Individual
DR. THOMAS A. FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
75 DORCHESTER ST, SOUTH BOSTON, MA 02127-2228
(617) 464-2227
(617) 268-4218
Mailing address
75 DORCHESTER ST, SOUTH BOSTON, MA 02127-2228
(617) 464-2227
(617) 268-4218
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2284
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
352504
HARVARD PILGRIM HEALTH
MA
01
—
Y36717
BLUE CROSS BLUE SHIELD
MA
Enumeration date
02/28/2007
Last updated
11/21/2016
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