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NPI Code Detail

MEDICARE: DR. JEFFREY STEPHEN FUGATE DO

MEDICARE: DR. JEFFREY STEPHEN FUGATE DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease PhysicianOS003906LPA
2207R00000XInternal Medicine PhysicianOS003906LPA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2060012835OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811990054
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEFFREY STEPHEN FUGATE DO
Provider Business Mailing Address
First Line : 307 S FRONT ST
Second Line : 1ST FLOOR
City : HARRISBURG
State : PA
Zip : 17104-1621
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2808 OLD POST ROAD
Second Line :
City : HARRISBURG
State : PA
Zip : 17110-3685
Country : US
Telephone Number : 717-920-4400
Fax Number : 717-920-4401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 07/27/2015

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