Individual
DR. NICHOLAS S. FOGELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
511 SW 10TH AVE STE 907, PORTLAND, OR 97205-2710
(503) 715-1377
(503) 715-2717
Mailing address
511 SW 10TH AVE STE 907, PORTLAND, OR 97205-2710
(503) 715-1377
(503) 715-2717
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
13367
HI
207V00000X
Obstetrics & Gynecology Physician
23610
SC
207VG0400X
Gynecology Physician
Primary
173545
OR
Other
Enumeration date
11/23/2005
Last updated
07/06/2021
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