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General NPI Number Information
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NPI Number | 1568573020
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Entity Type | Individual
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Provider Name | MARY DOROTHY FOGERTY MD
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 06/01/2009
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Provider Practice Location Address
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Address Line | 1211 MEDICAL CENTER DRIVE 11 SOUTH VUH
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City | NASHVILLE
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State | TN
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Zip | 37212
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Country | US
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Telephone | 615-936-0182
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Fax | 615-936-0185
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Provider Business Mailing Address
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Address Line | 1211 21ST AVENUE S. 404 MEDICAL ARTS BUILDING
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City | NASHVILLE
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State | TN
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Zip | 37212-1750
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Country | US
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Telephone | 615-936-0182
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Fax | 615-936-0185
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD0000037962
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License Number State | TN
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