Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Omotayo Olusola Fasan, MBBS

Individual provider Internal Medicine Physician · NPI 1386804409

Dr. Omotayo Olusola Fasan, MBBS is an Internal Medicine Physician in Charlotte, North Carolina. Works from 2 locations. Licensed in North Carolina and Pennsylvania.

Licensed in
NC, PA
In the registry since
2008
Specialties on file
6
What do these letters mean?
MBBS — Bachelor of Medicine, Bachelor of Surgery
The medical degree awarded in the UK, India and many Commonwealth countries; equivalent to an MD.

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Practice location Address checks out

125 Queens Rd Ste 600
Charlotte, NC 28204-3215
Phone: (980) 302-6600
Fax: (980) 302-6605
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 100 N Academy Ave, Danville, PA 17822-2001 — (570) 271-6045

Specialties & licences

Hematology (Internal Medicine) Physician (primary) Taxonomy 207RH0000X · Licence 2013-01292 (NC)
Internal Medicine Physician Taxonomy 207R00000X · Licence 2013-01292 (NC)
Internal Medicine Physician Taxonomy 207R00000X · Licence MD433151 (PA)
Internal Medicine Physician Taxonomy 207R00000X · Licence MT183411 (PA)
Hematology (Internal Medicine) Physician Taxonomy 207RH0000X · Licence MD433151 (PA)
Hematology (Internal Medicine) Physician Taxonomy 207RH0000X · Licence MT183411 (PA)

Record details

NPI number1386804409
Entity typeIndividual (Type 1)
GenderMale
Credentials MBBS
Sole proprietorNo
NPI enumeratedJune 12, 2008
Last updated in NPPESNovember 18, 2020
Certification dateNovember 18, 2020

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