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Individual

DR. CAROLINA FASOLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D., M.P.H.

Contact information

Practice address
200 QUEENS RD, SUITE 400, CHARLOTTE, NC 28204-3253
(704) 333-7376
Mailing address
200 QUEENS RD, SUITE 400, CHARLOTTE, NC 28204-3253
(704) 333-7376

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
2015-00752
NC
2085R0001X
Radiation Oncology Physician
38102
SC
2085R0001X
Radiation Oncology Physician
Primary
A121732
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1922346923
NC
05
NC2449
SC
Enumeration date
01/25/2013
Last updated
08/26/2015
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