Individual
DR. MICHAEL FORTGANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
36 TAMARACK AVE, PBM 118, DANBURY, CT 06811-4822
(203) 739-7532
(203) 743-2610
Mailing address
230 SAUGATUCK AVE, WESTPORT, CT 06880-6401
(203) 739-7532
(203) 743-2610
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
027366
CT
Other
Enumeration date
08/03/2006
Last updated
07/08/2007
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