Individual
AMY CATHERINE FOGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
323 S 18TH AVE, STURGEON BAY, WI 54235-1401
(920) 746-0510
Mailing address
323 S 18TH AVE, STURGEON BAY, WI 54235-1401
(920) 746-3666
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
390200000X
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51533
LICENSE
WI
Enumeration date
10/11/2006
Last updated
11/17/2023
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