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Licensee Information

Wylder Shepherd Fondaw - PA-C
0010-10234
Active
No
06/09/2020
02/15/2027

Active Supervisor

NameTypeStatusApprovedInactive
Miller, Brian Douglas, MD MD Active 07/21/2020
Occhino, Christopher Michael, MD MD Active 07/30/2024

North Carolina Hospital Admitting Privileges

Location
Annie Penn Hospital
Cone Health
Moses Cone Health System
Wesley Long Community Hospital, Inc.

Out of State Active/Inactive Licenses

State
Alaska

Out of Country Active/Inactive Licenses

Country
None Reported
Information loaded from this database is current as of 5/10/2026 12:05:53 PM
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