Individual
GINGER FEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
705 S GRAND ST, NASHVILLE, IL 62263-1534
(618) 327-2225
Mailing address
705 S GRAND ST, NASHVILLE, IL 62263-1534
(618) 327-2225
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.134709
IL
Other
Enumeration date
06/28/2011
Last updated
07/14/2014
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