SAMUEL ALLEN FAGENHOLZ (NPI# 1376549998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376549998 |
| Entity Type | Individual |
| Full Name | SAMUEL ALLEN FAGENHOLZ |
| Credential | MD |
| Practice Address |
300 State St Ste 301 Erie PA 16507-1430 |
| Practice Telephone | 8148777907 |
| Practice Fax Number | 8148776791 |
| Mailing Telephone | 8148777907 |
| Mailing Fax Number | 8148776791 |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2013-03-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | MD021621E | PA | Allopathic & Osteopathic Physicians |
| N | 2080P0214X |
Pediatrics Specialization: Pediatric Pulmonology |
MD021621E | PA | Allopathic & Osteopathic Physicians |
| Street Address |
300 STATE ST STE 301 |
| City | ERIE |
| State | PA |
| Zip Code | 16507-1430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902375876 | Rebecca Ann Swope | Nurse Practitioner | 300 State St Ste 301, Erie, PA 16507-1430 | 2018-11-20 |
| 1417134602 | Danielle M Gyorgak | Pediatrics | 300 State St Ste 301, Erie, PA 16507-1430 | 2008-01-30 |
| 1881663334 | Robert Patrick Burns | Pediatrics | 300 State St Ste 301, Erie, PA 16507-1430 | 2006-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275198723 | Ram Baboo | Student in an Organized Health Care Education/Training Program | 120 East 2nd Street Upmc Northshore Neurology, 3rd Floor, Erie, PA 16507 | 2019-05-09 |
| 1518431915 | Katrina L Putnam | Social Worker | 101 East Avenue, Erie, PA 16507 | 2019-01-18 |
| 1144712084 | Kathlyn Elise Callenius | Student in an Organized Health Care Education/Training Program | 120 East Second St, 3rd Floor, Erie, PA 16507 | 2018-06-06 |
| 1043707490 | Cecelia Anne Hollands | Counselor | 103 East Ave., Erie, PA 16507 | 2018-04-20 |
| 1336591239 | Zachary Dusckas | Student in an Organized Health Care Education/Training Program | 100 Peach St #400, Orthopaedics & Sports Medicine of Erie, Erie, PA 16507 | 2016-07-05 |
| 1679928329 | Stephanie Libra | Occupational Therapist | 100 Barber Place, Box # 29, Erie, PA 16507 | 2016-05-02 |
| 1821476243 | Colin Macelroy Vroome Jr. | Orthopaedic Surgery | Hand, Microsurgery, Reconstructive Orthopedics, LLP, 300 State St. Suite 205, Erie, PA 16507 | 2015-05-18 |
| 1255742227 | Danoushka Tememe | Psychiatry & Neurology | 120 East Second St., 3rd Floor, Erie, PA 16507 | 2014-05-13 |
| 1811307507 | David Aaron Hammer | Psychiatry & Neurology | 120 E Second Street Upmc North Shore Neurology, 7rd Floor, Erie, PA 16507 | 2014-05-02 |
| 1912330325 | Jeanine Krugger | Pharmacist | 363 East 6th St, Erie, PA 16507 | 2013-08-21 |
| Find all providers in zip 16507 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235479882 | Jack Gold | Pediatrics | 4425 Upland Dr, Erie, PA 16509-1654 | 2013-02-19 |
| 1467626283 | Ravi Kumar Chekka | Pediatrics | 1611 Peach St Ste 300, Erie, PA 16501-2122 | 2008-04-14 |
| 1811968498 | Stephanie F Russo | Pediatrics | 3910 Caughey Rd, Suite 170, Erie, PA 16506-4096 | 2006-01-31 |
| 1215917166 | Sant Ram | Pediatrics | 2123 W 8th St, Erie, PA 16505-4743 | 2006-01-18 |
| 1124029301 | Lynne M Birkmeyer | Pediatrics | 4022 Zuck Road, Your Pediatric Connection West, Erie, PA 16506-4592 | 2005-08-10 |
| 1780684589 | Andrea Javier Fadrigo | Pediatrics | 4022 Zuck Rd, Erie, PA 16506-4592 | 2005-07-22 |
| 1093718124 | Joseph C Barber | Pediatrics | 3580 Peach St, Erie, PA 16508-2776 | 2005-05-23 |
| 1487153144 | Pediatric Care Center of Erie, PC | Pediatrics | 1611 Peach St Ste 300, Erie, PA 16501-2122 | 2018-02-08 |
| 1861857534 | Children's Community Care | Pediatrics | 3910 Caughey Rd, Suite 170, Erie, PA 16506-4096 | 2015-12-23 |
| 1700276896 | Sviatlana Sirash | Pediatrics | 201 State St, Erie, PA 16550-0002 | 2015-01-28 |
| Find all providers in ERIE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.