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Individual

MARK E FOGLESONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1600 STATE STREET, SALEM, OR 97301
(503) 540-6300
Mailing address
1600 STATE STREET, SALEM, OR 97301
(503) 540-6300

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD19910
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
084269
OR
Enumeration date
07/26/2006
Last updated
02/13/2014
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