Individual
DR. ROBERT J. FANNING JR.
Active
Individual
DR. ROBERT J. FANNING JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
1431
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0077044000
—
WV
01
—
01431
HEALTH PLAN UOV
WV
05
—
0975039
—
OH
Enumeration date
06/22/2005
Last updated
03/07/2008
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