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GEORGE C-C FOGG MD PHD NPI 1811901085


NPI Information

NPI: 1811901085
Provider Name: GEORGE C-C FOGG, MD, PHD
Classification: Pediatrics - 2080P0208X
Entity Type: Individual

Specialization: Pediatric Infectious Diseases

PECOS Registration: Yes

Address:
330 BARCLAY AVE NE
SUITE 203
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 391-2313
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George C-c Fogg, MD, PHD is a pediatric infectious diseases pediatrics in Grand Rapids, MI. The provider is a pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments. George C-c Fogg, MD, PHD NPI is 1811901085. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

330 BARCLAY AVE NE
SUITE 203
GRAND RAPIDS, MI
ZIP 49503-556
Phone: (616) 391-2313

The NPI 1811901085 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/27/2006 and was last updated on 3/17/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics4301078543MICHIGANNo
22080P0208XPediatricsPediatric Infectious Diseases4301078543MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14627622MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.