Individual
MRS. CAROLYN ANN FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
75 E STREET RD, FEASTERVILLE TREVOSE, PA 19053-6047
(267) 684-1047
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA055688
PA
Other
Enumeration date
04/22/2009
Last updated
06/16/2021
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