Individual
MR. THOMAS M FITZGERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1350 MEDICAL CENTER DRIVE, STE B, ROHNERT PARK, CA 94928
(707) 586-9300
(707) 586-1252
Mailing address
1350 MEDICAL CENTER DRIVE, STE B, ROHNERT PARK, CA 94928
(707) 586-9300
(707) 586-1252
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
E3409
CA
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
E3409
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
E3409
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000E34090
BLUE SHIELD
CA
05
—
000E34090
—
CA
01
—
680159845
BLUE CROSS
CA
Enumeration date
06/09/2006
Last updated
05/16/2013
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