Individual
DANIEL FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
621 KELLY BLVD, SLIPPERY ROCK, PA 16057
(724) 794-4009
(724) 794-4099
Mailing address
621 KELLY BLVD, SLIPPERY ROCK, PA 16057-8523
(724) 794-4009
(724) 794-4099
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD040440L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012360630003
—
PA
Enumeration date
12/30/2005
Last updated
10/09/2020
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