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Individual

DR. MICHAEL JAMES FANNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
500 CORPORATE PKWY, SUITE 100, AMHERST, NY 14226-1263
(716) 631-0380
(716) 631-3229
Mailing address
500 CORPORATE PKWY, SUITE 100, AMHERST, NY 14226-1263
(716) 631-0380
(716) 631-3229

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
134690
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00786329
NY
Enumeration date
01/20/2006
Last updated
08/26/2009
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