Keva C Fothergill, PA

NPI #1285793935 in Norwich, Connecticut

Provider Information

NPI Number: 1285793935
Entity Type: Individual
Name: Keva C Fothergill, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Dec 8, 2006
Last Updated: Sep 4, 2013

Practice Location

Address: 26 LAFAYETTE ST
City: Norwich
State: Connecticut
ZIP Code: 06360-3408
Phone: (860) 889-7321

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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