Fogarty, Mark
Fogarty, Mark is an individual health care provider with primary practice located at 7419 Watson Rd , Saint Louis MO 63119-4415. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Fogarty, Mark can be contacted via phone (314) 400-3360.Contact Information
Primary practice address
7419 Watson Rd
Saint Louis MO 63119-4415
Phone: (314) 400-3360
Fax: (314) 400-3361
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 106500 | Missouri |
Profile Details
| NPI number | 1770577736 |
|---|---|
| LBN Legal business name | Fogarty, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 7th, 2005 |
| Last updated | Jun 29th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770577736 | NPPES |
| Missouri | MEDICAID | 209776202 |
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