Dr. Edward Costa Fourgas, M.D.
Radiology, Diagnostic Radiology in Wilkes Barre, PA. Individual provider (NPI-1).
NPI number1982805255
StatusActive
Last updated in NPPESAug 19, 2020
Details
- NPI
- 1982805255
- Entity type
- Individual (NPI-1)
- Name
- Dr. Edward Costa Fourgas
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 31, 2007
- Certification date
- Aug 19, 2020
- Last updated
- Aug 19, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0202X | Radiology, Diagnostic Radiology | MD448590 | PA | Yes |
| 2085D0003X | Radiology, Diagnostic Neuroimaging | 8232714-1205 | UT | |
| 2085N0700X | MD448590 | PA | ||
| 2085R0202X | Radiology, Diagnostic Radiology | 4301088547 | MI |
Practice location
1000 E Mountain BlvdWilkes Barre, PA 18711-0027
Phone 570-808-7779 · Fax 570-808-5390
Mailing address
100 N Academy AveDanville, PA 17822-4903
Phone 570-271-6144 · Fax 570-271-6578
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