Individual
BENJAMIN FAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
715 N SAINT JOSEPH AVE, HASTINGS, NE 68901-4451
(402) 461-5122
Mailing address
715 N SAINT JOSEPH AVE, HASTINGS, NE 68901-4451
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
23561
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025588700
—
NE
01
—
P00623703
RAILROAD MEDICARE
—
Enumeration date
04/09/2007
Last updated
10/03/2012
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