Individual
DR. TYLER FUGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
775 NORMAN DR, LEBANON, PA 17042-7497
(717) 274-5500
(717) 202-0130
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS013449
PA
207RC0000X
Cardiovascular Disease Physician
Primary
OS013449
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PO1680500
RAILROAD MEDICARE
PA
Enumeration date
01/17/2007
Last updated
11/04/2024
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