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General NPI Number Information
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NPI Number | 1003809005
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Entity Type | Individual
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Provider Name | JAMES A FUGAZZI M.D,
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Gender | Male
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Dates
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Enumeration Date | 08/24/2005
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Last Update Date | 01/05/2017
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Provider Practice Location Address
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Address Line | 5400 MACKINAW RD
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City | SAGINAW
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State | MI
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Zip | 48604-9515
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Country | US
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Telephone | 989-583-5250
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Fax | 989-583-5259
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Provider Business Mailing Address
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Address Line | 1447 N HARRISON ST
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City | SAGINAW
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State | MI
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Zip | 48602-4727
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Country | US
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Telephone | 989-583-5250
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Fax | 989-583-5259
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 35-086184
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | JF076329
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License Number State | MI
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