Individual provider Active NPI

David M Fajgenbaum, M.D.

  • Orthopaedic Surgery Physician
  • Raleigh, NC
National Provider Identifier
1376513630
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
24065 Issued in NC
Practice address
3410 Executive Dr
Ste # 103
Raleigh, NC 27609-7450
Phone
(919) 872-5296
Fax
(919) 850-9718
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 24065 NC Primary

Addresses

Primary practice location

3410 Executive Dr
Ste # 103
Raleigh, NC 27609-7450

Mailing address

3410 Executive Dr
Ste # 103
Raleigh, NC 27609-7450
Phone (919) 872-5296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1376513630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 EXECUTIVE DR",
            "address_2": "STE # 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097450",
            "telephone_number": "919-872-5296",
            "fax_number": "919-850-9718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 EXECUTIVE DR",
            "address_2": "STE # 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097450",
            "telephone_number": "919-872-5296",
            "fax_number": "919-850-9718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJGENBAUM",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "24065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.