DR. WILLIAM LI-GOON FAN (NPI# 1902884000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902884000 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM LI-GOON FAN |
| Credential | M.D. |
| Practice Address |
3604 Bush St 2nd Floor Raleigh NC 27609-7511 |
| Mailing Address |
3031 New Bern Ave Ste 306 Raleigh NC 27610-2989 |
| Practice Telephone | 9198767807 |
| Practice Fax Number | 9198768823 |
| Mailing Telephone | 9192313966 |
| Mailing Fax Number | 9192313912 |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2020-02-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
200200682 | NC | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 545 E Market St, Smithfield, NC 275773923 | 9198767807 | 9198768823 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912991415 | William Fan | Optometrist | 625 W Dickey Rd, Grand Prairie, TX 75051-3129 | 2005-09-12 |
| 1639299662 | William Fan | Chiropractor | 3635 Peachtree Industrial Blvd, Suite 500, Duluth, GA 30096-2806 | 2007-03-31 |
| Street Address |
3604 BUSH ST 2ND FLOOR |
| City | RALEIGH |
| State | NC |
| Zip Code | 27609-7511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891797049 | Wake Nephrology Associates, P.a. | Specialist | 3604 Bush St, Raleigh, NC 27609-7511 | 2005-06-01 |
| 1770901993 | Sarah Mistrot | Physician Assistant | 3604 Bush St, Raleigh, NC 27609-7511 | 2014-04-03 |
| 1508299777 | Shannon Joan Clark | Nurse Practitioner | 3604 Bush St, Raleigh, NC 27609-7511 | 2013-08-12 |
| 1568718336 | Nanci Jacqulyn Sullivan-blackert | Nurse Practitioner | 3604 Bush St, Raleigh, NC 27609-7511 | 2012-07-31 |
| 1699069948 | Robert Edward Olivo | Internal Medicine | 3604 Bush St, Raleigh, NC 27609-7511 | 2011-06-03 |
| 1679885107 | Lori Michelle Haskins | Nurse Practitioner | 3604 Bush St, Raleigh, NC 27609-7511 | 2010-07-13 |
| 1376602391 | Deborah B Berg | Dietitian, Registered | 3604 Bush St, Raleigh, NC 27609-7511 | 2006-12-06 |
| 1780796508 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 3604 Bush St, Raleigh, NC 27609-7511 | 2006-08-31 |
| 1386752228 | Jacqueline Suzanne Sebastian | Nurse Practitioner | 3604 Bush St, Raleigh, NC 27609-7511 | 2006-08-29 |
| 1366470791 | Donna Antonia Theodore | Physician Assistant | 3604 Bush St, Raleigh, NC 27609-7511 | 2006-06-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184235582 | Choice Service Solutions LLC | In Home Supportive Care | 5300 Six Fox Rd Siite205, Raleigh, NC 27609 | 2020-08-11 |
| 1003426073 | Rosana Oba -rovira | Registered Nurse | 5300 Six Fox Road, Suite 205, Raleigh, NC 27609 | 2020-08-05 |
| 1821612706 | Helen Alexandra Bonner | Physical Medicine & Rehabilitation | Hey Clinic Pa, 3320 Wake Forest Road Ste 450, Raleigh, NC 27609 | 2020-06-05 |
| 1215423579 | Appiah Nana Larbi | Social Worker | Easter Seals Ucp 4000 Wake Forest Rd Ste 200, Raleigh, NC 27609 | 2018-07-10 |
| 1215423777 | Broadway Home Care LLC | In Home Supportive Care | 107 Windel Dr Ste 105, Raleigh, NC 27609 | 2018-07-09 |
| 1275027948 | Lacey Allene Cottingham | Social Worker | 312 W Millbrook Rd Ste 129, Raleigh, NC 27609 | 2018-06-18 |
| 1447748819 | Integrated Dermatology of North Raleigh, Pllc | Dermatology | 3809 Computer Dr Ste 200, Raleigh, NC 27609 | 2018-05-01 |
| 1902325418 | Naomi Christine Askew | Nurse Practitioner | 3400 Wake Forest Drive, Bldg 9, Bldg #9, 4th Floor, Raleigh, NC 27609 | 2017-09-15 |
| 1962929679 | Alexia Montague | Social Worker | 1306 Paddock Drive Suite E-100, Raleigh, NC 27609 | 2017-08-23 |
| 1730602236 | Chantel Washington-mbuthia | Counselor | 1100 Logger Ct. Ste C100, Heartfelt Alternative Inc, Raleigh, NC 27609 | 2017-07-18 |
| Find all providers in zip 27609 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508360462 | North Carolina Nephrology Pa | Internal Medicine | 3604 Bush St Fl 2, Raleigh, NC 27609-7511 | 2018-03-23 |
| 1083168181 | Private Diagnostic Clinic, Pllc | Internal Medicine | 10207 Cerny St Ste 306, Raleigh, NC 27617-4879 | 2016-08-08 |
| 1104841436 | Karn Gupta | Internal Medicine | 3604 Bush Street, Raleigh, NC 27609 | 2006-07-13 |
| 1932101177 | Jeffrey Gordon Hoggard | Internal Medicine | 3031 New Bern Ave, Suite 100, Raleigh, NC 27610-1214 | 2005-06-01 |
| 1750835336 | North Carolina Nephrology Pa | Internal Medicine | 3031 New Bern Ave, Suite 306, Raleigh, NC 27610-2989 | 2016-08-11 |
| 1699069948 | Robert Edward Olivo | Internal Medicine | 3604 Bush St, Raleigh, NC 27609-7511 | 2011-06-03 |
| 1902087570 | Libbie Parker Mckenzie | Internal Medicine | Central Prison, 1300 Western Blvd, Raleigh, NC 27606 | 2007-11-23 |
| 1295951036 | So Yoon Jang | Internal Medicine | 3031 New Bern Ave, Ste. 306, Raleigh, NC 27610-2988 | 2007-04-18 |
| 1376769893 | Adam Stern | Internal Medicine | 3031 New Bern Ave, Suite 306, Raleigh, NC 27610-2988 | 2007-04-17 |
| 1700971173 | Eric Warren Raasch | Internal Medicine | 3031 New Bern Ave, Suite 306, Raleigh, NC 27610-2988 | 2006-10-03 |
| Find all providers in RALEIGH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.