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Individual

DR. MARTHA E FAGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1050 REID PARKWAY, SUITE 220, RICHMOND, IN 47374-1156
(765) 962-9541
(765) 966-5952
Mailing address
1050 REID PARKWAY, SUITE 220, RICHMOND, IN 47374-1156
(765) 962-9541
(765) 966-5952

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0101233798
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
01066632A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200946410
IN
05
3033461
OH
Enumeration date
01/19/2006
Last updated
05/13/2021
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