Fogg, George C-C

Fogg, George C-C is an individual health care provider with primary practice located at 330 Barclay Ave Ne Suite 203, Grand Rapids MI 49503-2556. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases. Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases is his primary health care specialty. Fogg, George C-C can be contacted via phone (616) 391-2313.

Contact Information

Primary practice address
330 Barclay Ave Ne Suite 203 Grand Rapids MI 49503-2556
Phone: (616) 391-2313
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301078543 Michigan
Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases 2080P0208X 4301078543 Michigan

Profile Details

NPI number 1811901085
LBN Legal business name Fogg, George C-C
Credentials MD, PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Mar 17th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1811901085 NPPES
Michigan MEDICAID 4627622

Popular Providers