Provider Demographics
NPI:1164452462
Name:SHUGAR, RONALD A (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:A
Last Name:SHUGAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2407
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08818-2407
Mailing Address - Country:US
Mailing Address - Phone:732-494-6300
Mailing Address - Fax:732-494-1028
Practice Address - Street 1:98 JAMES ST
Practice Address - Street 2:SUITE 104
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3902
Practice Address - Country:US
Practice Address - Phone:732-494-6300
Practice Address - Fax:732-494-1028
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA24920207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJOK9410OtherHEALTHNET
NJ1419609Medicaid
NJLP179OtherOXFORD
NJ096937CATMedicare PIN
NJ1419609Medicaid