IndividualActive
Jason Fangusaro, MD
NPI 1508891268 · Pediatric Hematology & Oncology Physician · Atlanta, GA
Provider details
- NPI number
- 1508891268
- Entity type
- Individual
- Primary specialty
- Pediatric Hematology & Oncology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 81195 (GA)
Practice location
1405 Clifton Rd Ne
Atlanta, GA 30322-1060
Phone: (404) 785-1112
Fax: (404) 785-6288
Mailing address
1405 Clifton Rd Ne
Atlanta, GA 30322-1060
Registry dates
- Enumerated
- 2006-07-11
- Last updated
- 2022-06-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.