Provider Demographics
NPI:1043546104
Name:DUGAY, TERRENCE ANTHONY I (SUBMARINE IDC)
Entity Type:Individual
Prefix:MR
First Name:TERRENCE
Middle Name:ANTHONY
Last Name:DUGAY
Suffix:I
Gender:M
Credentials:SUBMARINE IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5090 LIKINI ST
Mailing Address - Street 2:EAST TOWER UNIT # 1502
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-2375
Mailing Address - Country:US
Mailing Address - Phone:808-471-1017
Mailing Address - Fax:
Practice Address - Street 1:5090 LIKINI ST
Practice Address - Street 2:EAST TOWER UNIT# 1502
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818
Practice Address - Country:US
Practice Address - Phone:808-471-1017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman