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

Glen Anthony Fandetti, MD

Individual provider Internal Medicine Physician · NPI 1265656094

Glen Anthony Fandetti, MD is an Interventional Cardiology in Charlotte, North Carolina. Graduated from Georgetown University School of Medicine in 2000, 26 years ago. Practices with Carolinas Physicians Network Inc, a 2,328-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
26
Trained at
Georgetown University School of Medicine
Licensed in
NC
In the registry since
2007
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

101 E W T Harris Blvd Ste 1213
Charlotte, NC 28262-3485
Phone: (704) 863-1950
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 1237 Harding Pl, Charlotte, NC 28204 — (704) 373-0212
  • 10650 Park Rd, Charlotte, NC 28210-8538 — (704) 667-3840
  • 16455 Statesville Rd, Huntersville, NC 28078-7135 — (704) 863-1950
  • 1550 Faulk St, Monroe, NC 28112-5086 — (704) 667-3410

Specialties & licences

Interventional Cardiology Physician (primary) Taxonomy 207RI0011X · Licence 2008-01700 (NC)
Internal Medicine Physician Taxonomy 207R00000X · Licence 2008-01700 (NC)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 2008-01700 (NC)

Record details

NPI number1265656094
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 12, 2007
Last updated in NPPESJuly 17, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERVENTIONAL CARDIOLOGY
Also practisesCARDIOVASCULAR DISEASE (CARDIOLOGY), INTERNAL MEDICINE
Medical schoolGEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduated 2000 (26 years in practice)
Group practice Carolinas Physicians Network Inc — 2328 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations10 on file with Medicare

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