Individual provider · Type 1 NPI
Walter J. Fagan, MD
Vascular Surgery Physician · Jim Thorpe, PA
NPI number
1659703635
Active
Practice location
211 Center Ave
Jim Thorpe, PA 18229-1205
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Vascular Surgery Physician Primary | 2086S0129X | MD035284E (PA) |
Vascular Surgery Physician: A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
About NPI 1659703635
Walter J. Fagan, MD's National Provider Identifier is 1659703635, issued on Aug 1, 2013. The primary taxonomy on file is Vascular Surgery Physician (2086S0129X), and the practice location is in Jim Thorpe, PA. The record was last updated on Aug 1, 2013.