| Thomas M. Fogarty Md Pc | |
|
10369 Democracy Ln Suite A Fairfax VA 22030-2548 | |
| (703) 383-6933 | |
| (703) 383-6936 |
| Full Name | Thomas M. Fogarty Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 10369 Democracy Ln, Fairfax, Virginia |
| Authorized Official Name and Position | Nancy Donahue (OFFICE MANAGER) |
| Authorized Official Contact | 7033836933 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas M. Fogarty Md Pc 10369 Democracy Ln Suite A Fairfax VA 22030-2548 Ph: (703) 383-6933 | Thomas M. Fogarty Md Pc 10369 Democracy Ln Suite A Fairfax VA 22030-2548 Ph: (703) 383-6933 |
| NPI Number | 1750668109 |
|---|---|
| Provider Enumeration Date | 11/14/2011 |
| Last Update Date | 11/14/2011 |
| Medicare PECOS PAC ID | 5496914400 |
|---|---|
| Medicare Enrollment ID | O20120312000327 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750668109 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Thomas M Fogarty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760527469 PECOS PAC ID: 7517126527 Enrollment ID: I20120312000461 |
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