Individual
PHILIP D FITZGERALD
Active
Individual
PHILIP D FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25883
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000050938
ANTHEM / NCMA
KY
01
—
000023029B
HUMANA / NCMA
KY
01
—
008894
SIHO / NCMA
KY
01
—
1054792
PASSPORT / NCMA
KY
01
—
110132054
RAILROAD MEDICARE
KY
05
—
200532240
—
IN
01
—
2433726000
PASSPORT ADVANTAGE / NCMA
—
05
—
64258833
—
KY
Enumeration date
04/18/2006
Last updated
01/12/2021
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