Individual
ERIC G. FOGAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
117 KITE RD, SWAINSBORO, GA 30401-3231
(478) 289-1349
(478) 289-1300
Mailing address
PO BOX 879, SWAINSBORO, GA 30401-0879
(478) 289-1349
(478) 289-1300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
047902
GA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
47902
GA
207R00000X
Internal Medicine Physician
047902
GA
Other
Enumeration date
08/14/2006
Last updated
04/23/2021
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