NPI 1104879899 · live from the CMS NPI Registry
Shana D Fogarty, M.D.
Hospitalist in Coeur D Alene, ID. National Provider Identifier 1104879899, active.
NPI record
| NPI | 1104879899 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Hospitalist 208M00000X |
| Practice location | 2003 Kootenai Health Way, Coeur D Alene, ID 83814 |
| Practice phone | 208-625-5085 |
| Enumerated | May 17, 2006 |
| Last updated | December 22, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine | 207Q00000X | MD61238314 (WA) |
| Family Medicine, Hospice and Palliative Medicine | 207QH0002X | MD61238314 (WA) |
| Hospitalist | 208M00000X | MD61238314 (WA) |
| Hospitalist primary | 208M00000X | M8664 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.