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Individual

DR. STEVEN TEDD FOGEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-2569
(573) 882-2226
Mailing address
4904 THORNBROOK RDG, COLUMBIA, MO 65203-9750
(157) 335-5142

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R8071
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201302338
MO
05
629589513A
GA
Enumeration date
05/16/2006
Last updated
03/15/2021
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