Provider Demographics
NPI:1043347560
Name:DUGAS, MICHAEL A
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:A
Last Name:DUGAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 MOGADOR RD
Mailing Address - Street 2:
Mailing Address - City:STEUBEN
Mailing Address - State:ME
Mailing Address - Zip Code:04680-3573
Mailing Address - Country:US
Mailing Address - Phone:207-546-2626
Mailing Address - Fax:
Practice Address - Street 1:512 MOGADOR RD
Practice Address - Street 2:
Practice Address - City:STEUBEN
Practice Address - State:ME
Practice Address - Zip Code:04680-3573
Practice Address - Country:US
Practice Address - Phone:207-546-2626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEALS2572OtherASSISTED HOUSING