Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 2011-01261 | NC |
N | 207VG0400X | Gynecologist | 2011-01261 | NC |
N | 207VX0000X | Obstetrician | 2011-01261 | NC |
NPI | 1154653723 |
---|---|
Provider Name | Rongrong Fan |
First Address | Asheville, NC 28803-2868 |
Second Address | Asheville, NC 28803-2868 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2010 |
Last Update Date | 25/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1154653723 | (05) | NC |
NCD535A | PTAN (01) | NC |