Individual
DR. JAMES DANIEL FOGARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
394 SINGLETON RIDGE RD, CONWAY, SC 29526-9150
(843) 347-8765
(843) 347-3499
Mailing address
2234 COLONIAL BLVD, MANAGED CARE DEPT., FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
DO983
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000254045
UNISON HEALTH PLAN
SC
05
—
009831
—
SC
05
—
5919732
—
NC
01
—
775936
WELLCARE
SC
01
—
8495790
CIGNA
SC
01
—
9041280
AETNA
SC
05
—
GP4522
—
SC
01
—
P00605413
RAILROAD MEDICARE
SC
Enumeration date
05/23/2006
Last updated
12/29/2016
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