Mark J Fagan (NPI# 1962449686, PAC ID# 2668456823) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1962449686 |
| PAC ID by PECOS | 2668456823 |
| Professional Enrollment ID | I20040615001369 |
| Full Name | Mark J Fagan |
| Organization Legal Name | BROWN MEDICINE |
| Address |
111 Plain St Fl 2 Providence RI 02903-4816 |
| Phone Number | 4014441770 |
| Gender | M |
| Credential | MD |
| Medical School | NEW YORK MEDICAL COLLEGE |
| Graduation Year | 1979 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 0446159776 |
| Number of Group Practice Members | 208 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 410007 | RHODE ISLAND HOSPITAL |
| 410012 | THE MIRIAM HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 111 Plain St, Fl 2, Providence, RI 02903-4816 | 4014441770 | BROWN MEDICINE |
| 593 Eddy St, Providence, RI 02903-4923 | 4014444741 | BROWN MEDICINE |
| Organization Legal Name | BROWN MEDICINE |
| Physicians | 201 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tonslyn A Toure | Endocrinology | Brown Medicine | 375 Wampanoag Trl, Riverside, RI 02915-2232 |
| Allan R Tunkel | Infectious Disease | Brown Medicine | 164 Summit Ave Fain Bldg B, Providence, RI 02906-2894 |
| Steven F Moss | Gastroenterology | Brown Medicine | 43 Jefferson Blvd, Suite 2, Warwick, RI 02888-1078 |
| Reginald Y Gohh | Nephrology | Brown Medicine | 250 Centerville Rd, Bldg E, Warwick, RI 02886-4400 |
| Paul Breiding | Internal Medicine | Brown Medicine | 909 N Main St, Suite 300, Providence, RI 02904-5752 |
| Martha C Trimbur | Internal Medicine | Brown Medicine | 593 Eddy St, Providence, RI 02903-4923 |
| Cheston Cunha | Infectious Disease | Brown Medicine | 593 Eddy St, Providence, RI 02903-4923 |
| Thomas D Denucci | Internal Medicine | Brown Medicine | 375 Wampanoag Trl, Riverside, RI 02915-2232 |
| Ross W Hilliard | Internal Medicine | Brown Medicine | 593 Eddy St, Providence, RI 02903-4923 |
| Donna Rondeau Marzullo | Nurse Practitioner | Brown Medicine | 593 Eddy St, Providence, RI 02903-4923 |
| Street Address |
111 PLAIN ST FL 2 |
| City | PROVIDENCE |
| State | RI |
| Zip | 02903-4816 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jenny R Donahue | Physical Therapy | Episcopal Housing Foundation of Rhode Island | 289 N Main St, Providence, RI 02903-1223 |
| Paige Elizabeth Caffrey | Occupational Therapy | Fox Rehab of Ri PC | 10 Dorrance St, Suite 700, Providence, RI 02903-2014 |
| Marcy E Bernstein | General Surgery | Vohra Wound Physicians of Fl LLC | 10 Dorrance St, Suite 700, Providence, RI 02903-2014 |
| Sharon Ann Gapasin | Qualified Speech Language Pathologist | Fox Rehab of Ri PC | 10 Dorrance St, Suite 700, Providence, RI 02903-2014 |
| Michael David Bertoncini | Physical Therapy | Fox Rehab of Ri PC | 10 Dorrance St, Suite 700, Providence, RI 02903-2014 |
| Jonathan Sorensen | Physical Therapy | Fox Rehab of Ri PC | 10 Dorrance St, Suite 700, Providence, RI 02903-2014 |
| Ann Marie Rameika | Nurse Practitioner | Practitioner Support Services LLP | 10 Dorrance St, Suite 700, Providence, RI 02903-2014 |
| Amy Beth Ciarniello | Physical Therapy | Fox Rehab of Ri PC | 10 Dorrance St, Suite 700, Providence, RI 02903-2014 |
| Dina Mccamish | Physical Therapy | Fox Rehab of Ri PC | 10 Dorrance St, Suite 700, Providence, RI 02903-2014 |
| Alicia Marie Marshall | Occupational Therapy | Fox Rehab of Ri PC | 10 Dorrance St, Suite 700, Providence, RI 02903-2014 |
| Find all physicians in zip 02903 | |||
| City | PROVIDENCE |
| Zip Code | 02903 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | PROVIDENCE + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Mark J Fagan.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.