Individual
DR. NERVIN HAFEZ FANOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
875 OAK ST SE STE 5020, SALEM, OR 97301-3997
(503) 371-4044
Mailing address
PO BOX 13129, SALEM, OR 97309-1129
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
01065400A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MD160136
OR
Other
Enumeration date
06/13/2008
Last updated
12/28/2018
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