Individual
CHARLES G. FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
832 PRINCETON AVE SW, BIRMINGHAM, AL 35211-1320
(205) 503-4281
(205) 503-4285
Mailing address
P.O. BOX 12366, BIRMINGHAM, AL 35202-2366
(205) 780-7101
(205) 206-8338
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
13522
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051556458
—
AL
Enumeration date
10/05/2006
Last updated
08/01/2008
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