MR. Mitchell John Fogal, PA-C

NPI #1407101538 in Holland, Michigan

Provider Information

NPI Number: 1407101538
Entity Type: Individual
Name: MR. Mitchell John Fogal, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jul 15, 2012
Last Updated: Oct 10, 2025

Practice Location

Address: 370 N 120TH AVE STE 20
City: Holland
State: Michigan
ZIP Code: 49424-2196
Phone: (616) 396-5855

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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