Individual
DR. MARK W. FUGATE
Active
Individual
DR. MARK W. FUGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD44206
TN
2086S0129X
Vascular Surgery Physician
Primary
44206
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1515384
—
TN
05
—
163534
—
AL
01
—
4230402
BCBS
TN
05
—
540820812A
—
GA
01
—
P00741318
RR MEDICARE
—
Enumeration date
07/17/2007
Last updated
06/02/2020
Update your record
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