Individual
DR. JOHN P FOGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28 CENTRE DR, MILTON, VT 05468-3104
(802) 847-4322
Mailing address
182 YACHT HAVEN DR, SHELBURNE, VT 05482-7774
(802) 985-2755
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01577682
—
NY
05
—
OVN1176
—
VT
Enumeration date
07/10/2006
Last updated
07/08/2007
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