David M Fajgenbaum MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

24065 Issued in NC

Legal business name

DAVID M FAJGENBAUM MD PA

Practice address

3410 Executive Dr
Suite #103
Raleigh, NC 27609-7457

Phone

(919) 872-5296

Fax

(919) 850-9718

NPI assigned

Feb 22, 2008

Organization subpart

No

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

Authorized official

Name

Mr. David M Fajgenbaum, M.D.

Title

Physician

Phone

(919) 872-5296

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1203638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352332800000",
    "number": "1942479050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 EXECUTIVE DR",
            "address_2": "SUITE #103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097457",
            "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": "SUITE #103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097457",
            "telephone_number": "919-872-5296",
            "fax_number": "919-850-9718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID M FAJGENBAUM MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-22",
        "last_updated": "2012-11-08",
        "status": "A",
        "authorized_official_last_name": "FAJGENBAUM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "919-872-5296",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NC",
            "license": "24065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Davidian & Associates

• Specialist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; 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.