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General NPI Number Information
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NPI Number | 1588022818
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Entity Type | Individual
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Provider Name | ELI FOUERTE D.O
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Gender | Male
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Dates
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Enumeration Date | 02/01/2016
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Last Update Date | 02/29/2024
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Provider Practice Location Address
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Address Line | 1221 S GEAR AVE
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City | WEST BURLINGTON
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State | IA
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Zip | 52655-1679
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Country | US
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Telephone | 646-206-4836
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Fax |
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Provider Business Mailing Address
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Address Line | 2351 E 4TH ST
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City | BROOKLYN
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State | NY
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Zip | 11223-5425
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Country | US
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Telephone | 646-206-4836
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Fax |
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | DO-04850
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | DO-04850
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MB09928100
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License Number State | NJ
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