Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 9700951 | NC |
NPI | 1053359836 |
---|---|
Provider Name | Dr. James E Fogartie JR. |
First Address | Raleigh, NC 27604-0010 |
Second Address | Raleigh, NC 27610-1231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 24/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1065X | BLUE CROSS BLUE SHIELD (01) | NC |
3752662 | UNITEDHEALTHCARE (01) | NC |
5636076 | AETNA (01) | NC |
802153 | PARTNERS MEDICARE (01) | NC |
891065X | (05) | NC |
B91695 | (02) | NC |
C6339 | MEDCOST (01) | NC |
P00016340 | MEDICARE RAILROAD (01) | NC |