Individual
ELAINE MICHELLE FOGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
220 E SPRING VALLEY PIKE STE 200, CENTERVILLE, OH 45458-2653
(937) 436-3117
(937) 436-0730
Mailing address
220 E SPRING VALLEY PIKE, CENTERVILLE, OH 45458-2653
(937) 436-3117
(937) 436-0730
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35125822
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0125437
—
OH
Enumeration date
03/25/2012
Last updated
04/15/2025
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