Individual
LEONARDO G FUGOSO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
733 W CLAIREMONT AVE, EAU CLAIRE, WI 54701-6101
(715) 838-5222
Mailing address
1400 BELLINGER ST, EAU CLAIRE, WI 54703-5222
(715) 838-5222
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
002949
NY
2084N0400X
Neurology Physician
Primary
60170
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538358098
—
WI
Enumeration date
10/22/2007
Last updated
09/11/2020
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