| Charles M Fogarty, Md, Pa | |
|
2030 North Church Place Spartanburg SC 29303-4276 | |
| (864) 582-6858 | |
| (864) 585-0999 |
| Full Name | Charles M Fogarty, Md, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 2030 North Church Place, Spartanburg, South Carolina |
| Authorized Official Name and Position | Darla M Brown (OFFICE MANAGER) |
| Authorized Official Contact | 8645826858 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles M Fogarty, Md, Pa Po Box 4276 Spartanburg SC 29305-4276 Ph: (864) 582-6858 | Charles M Fogarty, Md, Pa 2030 North Church Place Spartanburg SC 29303-4276 Ph: (864) 582-6858 |
| NPI Number | 1801936877 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 03/30/2012 |
| Medicare PECOS PAC ID | 9739179102 |
|---|---|
| Medicare Enrollment ID | O20040517000915 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801936877 | NPI | - | NPPES |
| 086917 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 08691 (South Carolina) | Secondary |
| 207RP1001X | Internal Medicine - Pulmonary Disease | 08691 (South Carolina) | Primary |
| Provider Name | Charles M Fogarty |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1316919194 PECOS PAC ID: 6406846880 Enrollment ID: I20070904000173 |
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