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Individual

DR. ROBERT J. FANNING JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1307 MT. DECHANTAL ROAD, WHEELING, WV 26003
(304) 242-1273
(304) 242-1422
Mailing address
13 STONEGATE, WHEELING, WV 26003
(304) 242-1273
(304) 242-1422

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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