Provider Demographics
NPI:1588605943
Name:FOGERTY, ANNEMARIE E (MD)
Entity Type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:E
Last Name:FOGERTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:YAWKEY 7B
Mailing Address - Street 2:MASSACHUSETTS GENERAL HOSPITAL
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-0000
Mailing Address - Country:US
Mailing Address - Phone:617-724-4000
Mailing Address - Fax:617-643-0798
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:YAWKEY 7B
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-724-4000
Practice Address - Fax:617-643-0798
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA225833207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology