Individual
KEVIN T FOGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 LACKAWANNA AVE STE 200, SCRANTON, PA 18503-2001
(484) 884-4500
(570) 800-7529
Mailing address
5325 NORTHGATE DR, SUITE 100, BETHLEHEM, PA 18017-9411
(610) 691-8931
(610) 691-8947
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD044115L
PA
Other
Enumeration date
11/04/2005
Last updated
07/14/2022
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