Organization
DAVID FAGAN, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE L BRILL CPC (OFFICE MANAGER)
(603) 747-2900
Entity
Organization
Contact information
Practice address
79 SWIFTWATER RD, SUITE 2, WOODSVILLE, NH 03785-1447
(603) 747-2900
(603) 747-2992
Mailing address
79 SWIFTWATER RD, SUITE 2, WOODSVILLE, NH 03785-1447
(603) 747-2900
(603) 747-2992
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
8707
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2165
—
VT
05
—
80002165
—
NH
01
—
FAGA18669
VT BC
VT
Enumeration date
06/25/2007
Last updated
01/22/2008
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