Provider Demographics
NPI:1932190261
Name:FAKADEJ, ANNA FRANCES (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:FRANCES
Last Name:FAKADEJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2170 MIDLAND RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-2927
Mailing Address - Country:US
Mailing Address - Phone:910-295-2100
Mailing Address - Fax:910-295-3625
Practice Address - Street 1:2170 MIDLAND RD
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-2927
Practice Address - Country:US
Practice Address - Phone:910-295-2100
Practice Address - Fax:910-295-3625
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9701744207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891097XMedicaid
SCN01745Medicaid
180034436OtherRAILROAD MEDICARE
NC83520OtherMEDCOST
2247575OtherDMERC
NC364186OtherMAMSI
NC1097XOtherBCBS
NC0838864OtherUNITED HEALTHCARE
NCFH2000135OtherFIRSTCAROLINACARE
NCFH2000135OtherFIRSTCAROLINACARE
NC1097XOtherBCBS
2247575OtherDMERC
NC0838864OtherUNITED HEALTHCARE