Individual
DR. BONNIE W FANELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1616 DOCTORS CIR, WILMINGTON, NC 28401-7406
(910) 769-2740
(910) 769-3622
Mailing address
1616 DOCTORS CIR, WILMINGTON, NC 28401-7406
(910) 769-2740
(910) 769-3622
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1187
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09008
BCBSNC PROVIDER ID
NC
05
—
7909008
—
NC
Enumeration date
06/14/2006
Last updated
03/02/2017
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