Provider Demographics
NPI:1962636274
Name:AUGUSTO P. FOJAS, MD
Entity Type:Organization
Organization Name:AUGUSTO P. FOJAS, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTO
Authorized Official - Middle Name:P
Authorized Official - Last Name:FOJAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-537-3860
Mailing Address - Street 1:1800 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:OH
Mailing Address - Zip Code:43964-1949
Mailing Address - Country:US
Mailing Address - Phone:740-537-3860
Mailing Address - Fax:740-537-3890
Practice Address - Street 1:1800 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:TORONTO
Practice Address - State:OH
Practice Address - Zip Code:43964-1949
Practice Address - Country:US
Practice Address - Phone:740-537-3860
Practice Address - Fax:740-537-3890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-14
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35034112207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0072566000Medicaid
OH0214191Medicaid
OH0379763Medicare PIN