Provider Demographics
NPI:1174526297
Name:FEARNOW, EDGAR CECIL III (MD)
Entity type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:CECIL
Last Name:FEARNOW
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4216
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17604-4216
Mailing Address - Country:US
Mailing Address - Phone:717-394-6028
Mailing Address - Fax:717-394-9223
Practice Address - Street 1:555 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2250
Practice Address - Country:US
Practice Address - Phone:717-394-9223
Practice Address - Fax:717-394-9223
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD052054L2085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA23-3102793OtherTAX ID - LANCASTER PET IMAGING
PA231855378OtherTAX ID - LANC RADIOLOGY
PA33-1011386OtherTAX ID - MRI GROUP
PA23-3102793OtherTAX ID - LANCASTER PET IMAGING
PA33-1011386OtherTAX ID - MRI GROUP
PA231855378OtherTAX ID - LANC RADIOLOGY
PA758076Medicare PIN
PA758076YYYMedicare PIN