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Individual

DOUGLAS S FUGATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
720 W MAHONING ST, SUITE 200, PUNXSUTAWNEY, PA 15767-1308
(814) 938-0740
(814) 938-0750
Mailing address
120 IRMC DR, SUITE160, INDIANA, PA 15701-3674
(724) 465-2676
(724) 349-1830

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
MD034740E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0014272070003
PA
01
CI1160
RAILROAD MEDICARE
PA
Enumeration date
03/25/2006
Last updated
04/25/2016
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