Individual
DR. JEFFREY STEPHEN FUGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2808 OLD POST ROAD, HARRISBURG, PA 17110-3685
(717) 920-4400
(717) 920-4401
Mailing address
307 S FRONT ST, 1ST FLOOR, HARRISBURG, PA 17104-1621
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS003906L
PA
207RC0000X
Cardiovascular Disease Physician
Primary
OS003906L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000845786
—
PA
01
—
060012835
RAILROAD MEDICARE
—
Enumeration date
05/23/2005
Last updated
07/27/2015
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