| NPI | 1376644625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J FANNING Cardiologist 304-242-1273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: WV 1431) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WV 46155) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2014-11-25 |