Provider Demographics
NPI:1114126885
Name:SHEARD&DRUGGE, P.C
Entity Type:Organization
Organization Name:SHEARD&DRUGGE, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RHETT
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:DRUGGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-324-5719
Mailing Address - Street 1:50 GLENBROOK RD
Mailing Address - Street 2:UNIT 1C
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2969
Mailing Address - Country:US
Mailing Address - Phone:203-324-5719
Mailing Address - Fax:203-323-7485
Practice Address - Street 1:50 GLENBROOK RD
Practice Address - Street 2:UNIT 1C
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2969
Practice Address - Country:US
Practice Address - Phone:203-324-5719
Practice Address - Fax:203-323-7485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT032482174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010032482CT01OtherANTHEM BCBS
CT020059OtherHEALTH NET
CTE68271Medicare UPIN