Individual
DR. JAMES STEVEN FENOGLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
01028954
IN
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036103995
IL
Other
Enumeration date
02/07/2008
Last updated
07/30/2013
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