Fugate, Mark W.

Fugate, Mark W. is an individual health care provider with primary practice located at 2501 Citico Ave , Chattanooga TN 37404-1127. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Fugate, Mark W. can be contacted via phone (423) 697-2000.

Contact Information

Primary practice address
2501 Citico Ave Chattanooga TN 37404-1127
Phone: (423) 697-2000
Fax: (423) 697-2320
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD44206 Tennessee
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 44206 Tennessee

Profile Details

NPI number 1124227459
LBN Legal business name Fugate, Mark W.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2007
Last updated Jun 2nd, 2020 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124227459 NPPES
Other P00741318 RR MEDICARE
Other 4230402 RR MEDICARE
MEDICAID 1515384 RR MEDICARE
MEDICAID 163534 RR MEDICARE
MEDICAID 540820812A RR MEDICARE

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