Healthcare Provider Details

I. General information

NPI: 1588855795
Provider Name (Legal Business Name): GREGORY P. FOTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 PARK AVE
BALTIMORE MD
21201-5633
US

IV. Provider business mailing address

2140 PEACHTREE RD NW SUITE 232
ATLANTA GA
30309-1314
US

V. Phone/Fax

Practice location:
  • Phone: 404-231-4431
  • Fax: 404-231-5677
Mailing address:
  • Phone: 404-231-4431
  • Fax: 404-231-5677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD432186
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD432186
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: