Provider Demographics
NPI:1801894456
Name:FITZGERALD, JEAN O (MD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:O
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:708 N SHADY RETREAT RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2503
Mailing Address - Country:US
Mailing Address - Phone:215-340-2229
Mailing Address - Fax:215-340-1753
Practice Address - Street 1:708 N SHADY RETREAT RD
Practice Address - Street 2:SUITE 7
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2503
Practice Address - Country:US
Practice Address - Phone:215-340-2229
Practice Address - Fax:215-340-1753
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD042716E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E61962Medicare UPIN
PA564685N63Medicare ID - Type Unspecified