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ERIC G. FOGAM MD

Emergency Medical Services >> Emergency Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1487667234

Individual Registrant:
 ERIC G. FOGAM MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
117 KITE RD  SWAINSBORO, GA 30401-3231 US
Tel: 478-289-1349  Fax: 478-289-1300

Contact information for business:
PO BOX 879  SWAINSBORO, GA 30401-0879 US
Tel: 478-289-1349  Fax: 478-289-1300

Registration Information:
NPI: 1487667234
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207PE0004XAllopathic & Osteopathic Physicians
Emergency Medicine
Emergency Medical Services
GA47902
N207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
GA047902
Y207P00000XAllopathic & Osteopathic Physicians
Emergency Medicine
GA047902

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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