Individual
C DOUGLAS FOGG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4499 ACUSHNET AVE, NEW BEDFORD REHABILITATION HOSPITAL, NEW BEDFORD, MA 02745
(508) 985-9082
(508) 995-0742
Mailing address
55 HIDDEN BAY DRIVE, SOUTH DARTMOUTH, MA 02748
(508) 993-1317
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
33680
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0162361
—
MA
Enumeration date
05/01/2006
Last updated
07/08/2007
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