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Individual

DR. WILLIAM MARTIN FOGARTY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
275 BLACKMER PL, SAINT LOUIS, MO 63119-3622
(314) 961-2062
Mailing address
275 BLACKMER PL, SAINT LOUIS, MO 63119-3622
(314) 961-2062

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2002002022
MO

Other

Enumeration date
07/20/2006
Last updated
07/08/2007
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