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Individual

MITCHELL ANDREW FOGEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
900 MADISON AVE, SUITE 209, BRIDGEPORT, CT 06606-5534
(203) 335-0195
(203) 335-7293
Mailing address
900 MADISON AVE, SUITE 209, BRIDGEPORT, CT 06606-5534
(203) 335-0195
(203) 335-7293

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
030630
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001306308
CT
Enumeration date
07/14/2005
Last updated
07/09/2015
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