IndividualActive
Omotayo Fasan, MBBS
NPI 1386804409 · Hematology (Internal Medicine) Physician · Charlotte, NC
Provider details
- NPI number
- 1386804409
- Entity type
- Individual
- Primary specialty
- Hematology (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MBBS
- Sex
- Male
- Sole proprietor
- No
- License
- 2013-01292 (NC)
Practice location
125 Queens Rd Ste 600
Charlotte, NC 28204-3215
Phone: (980) 302-6600
Fax: (980) 302-6605
Mailing address
Po Box 60447
Charlotte, NC 28260-0447
Registry dates
- Enumerated
- 2008-06-12
- Last updated
- 2020-11-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.