Individual
DAVID S FAGAN
Active
Individual
DAVID S FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
NH8707
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110095743
RRMCR
—
01
—
11P018
MVP
VT
01
—
137310
CIGNA SCRANTON
PA
05
—
2165
—
VT
05
—
80002165
—
NH
01
—
ANTHEM
BLUE CROSS BLUE SHIELD
NH
01
—
FAGA18669
VT BC BS
VT
Enumeration date
07/03/2006
Last updated
03/26/2010
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