Individual
FREDERICK C FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3623 J DEWEY GRAY CIR, SUITE 313, AUGUSTA, GA 30909-6511
(706) 860-9066
(706) 855-8842
Mailing address
3623 J DEWEY GRAY CIR, SUITE 313, AUGUSTA, GA 30909-6511
(706) 860-9066
(706) 855-8842
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19161
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2860FE
BC PROVIDER NUMBER
GA
01
—
908977
MEDICAID PROVIDER NUMBER
SC
Enumeration date
02/23/2006
Last updated
07/09/2007
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