| Evan Fogha, | |
|
455 Saint Michaels Dr, Santa Fe, NM 87505-7601 | |
| (505) 983-3361 | |
| Not Available |
| Full Name | Evan Fogha |
|---|---|
| Gender | Male |
| Speciality | Hospitalist |
| Experience | 10 Years |
| Location | 455 Saint Michaels Dr, Santa Fe, New Mexico |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619363405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208M00000X | Hospitalist | MD2018-0085 (New Mexico) | Primary |
| 207R00000X | Internal Medicine | MD2018-0085 (New Mexico) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Christus St Vincent Regional Medical Center | Santa fe, NM | Hospital |
| University Of New Mexico Hospital | Albuquerque, NM | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Unm Medical Group Inc | 4981795267 | 1000 |
| St Vincent Hospital | 6608775135 | 279 |
| Entity Name | St Vincent Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578587150 PECOS PAC ID: 6608775135 Enrollment ID: O20040105000372 |
| Entity Name | Unm Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831218627 PECOS PAC ID: 4981795267 Enrollment ID: O20070801000589 |
| Entity Name | Hospitalist Medicine Physicians Of Texas Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629307095 PECOS PAC ID: 3476688318 Enrollment ID: O20151019001400 |
| Entity Name | Hospitalist Medicine Physicians Of New Mexico-tcg Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376022822 PECOS PAC ID: 7810248218 Enrollment ID: O20180925000799 |
| Mailing Address | Practice Location Address |
|---|---|
| Evan Fogha, Po Box 648, Hanover, MD 21076-0648 Ph: (304) 598-4850 | Evan Fogha, 455 Saint Michaels Dr, Santa Fe, NM 87505-7601 Ph: (505) 983-3361 |
Dr. Mehul Daulat, D.O. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 4001 Rodeo Rd, Santa Fe, NM 87507 Phone: 505-780-8381 Fax: 505-467-8521 |