Individual
DR. JOSHUA RUSSELL FAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-1016
(608) 263-9729
(608) 263-0682
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
72671
WI
2085R0202X
Diagnostic Radiology Physician
2018002740
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200063238
—
MO
Enumeration date
04/24/2014
Last updated
06/05/2023
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