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Individual

DR. FAN XI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2800 ASHTON DRIVE, SUITE 100, WILMINGTON, NC 28412-2486
(910) 794-8892
(910) 794-8895
Mailing address
2800 ASHTON DRIVE, SUITE 100, WILMINGTON, NC 28412-2486
(910) 794-8892
(910) 794-8895

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
200501873
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5902676
NC
Enumeration date
07/12/2006
Last updated
09/18/2014
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