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Individual

NORMAN FOGLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6910 HILLSDALE CT, INDIANAPOLIS, IN 46250-2040
(317) 621-6337
(317) 621-6366
Mailing address
6626 E. 75TH STREET, SUITE 500, INDIANAPOLIS, IN 46250-2890

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01025348A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000313343
ANTHEM
IN
05
100057930
IN
01
P00971550
RR MEDICARE PTAN
IN
Enumeration date
07/28/2006
Last updated
11/27/2023
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