Individual
JOHN FARDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1525 LOS ALTOS PKWY, SPARKS, NV 89436-6692
(775) 982-5000
Mailing address
1155 MILL ST # M-14, RENO, NV 89502-1576
(775) 982-5262
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD214657
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
03/30/2020
Last updated
06/25/2025
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