Individual
RODGER E FAGERBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
743 JEFFERSON AVE STE 104, SCRANTON, PA 18510-1636
(570) 342-5253
(570) 342-6038
Mailing address
743 JEFFERSON AVE STE 104, SCRANTON, PA 18510-1636
(570) 342-5253
(570) 342-6038
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MD019917E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007992800003
—
PA
Enumeration date
07/04/2006
Last updated
07/21/2022
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