Individual
MS. FAWN SERENE CALLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2707 MEDICAL OFFICE PL, GOLDSBORO, NC 27534-9458
(919) 735-9146
(919) 735-0582
Mailing address
103 DOE COURT, HAMPSTEAD, NC 28443
(910) 214-0475
(919) 735-0582
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
101963
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00238952
RETIRED RAILROAD MEDICARE
NC
Enumeration date
12/14/2005
Last updated
02/27/2023
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