Individual
ROBERT JAMES FAGERHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 4TH ST SW, MASON CITY, IA 50401-2800
(641) 422-7000
Mailing address
24151 HAZEL RD, ELKPORT, IA 52044-8320
(563) 245-1547
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31364
IA
Other
Enumeration date
07/05/2006
Last updated
07/08/2007
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