| Fanous Clinic Medical Group Pc | |
|
9200 Woodhall Lake Dr Waxhaw NC 28173-6998 | |
| (216) 659-5992 | |
| Not Available |
| Full Name | Fanous Clinic Medical Group Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9200 Woodhall Lake Dr, Waxhaw, North Carolina |
| Authorized Official Name and Position | Hany Farag (OWNER) |
| Authorized Official Contact | 2166595992 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fanous Clinic Medical Group Pc 9200 Woodhall Lake Dr Waxhaw NC 28173-6998 Ph: (216) 659-5992 | Fanous Clinic Medical Group Pc 9200 Woodhall Lake Dr Waxhaw NC 28173-6998 Ph: (216) 659-5992 |
| NPI Number | 1275249898 |
|---|---|
| Provider Enumeration Date | 01/26/2023 |
| Last Update Date | 03/28/2024 |
| Medicare PECOS PAC ID | 9931552874 |
|---|---|
| Medicare Enrollment ID | O20240127000108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275249898 | NPI | - | NPPES |
| Provider Name | Hany Farag |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538362066 PECOS PAC ID: 8426100074 Enrollment ID: I20190826002068 |
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