Provider Demographics
NPI:1275526899
Name:DUGAN, JAMES ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ANDREW
Last Name:DUGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8091 TOWNSHIP LINE RD
Mailing Address - Street 2:STE 109
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260
Mailing Address - Country:US
Mailing Address - Phone:317-802-9900
Mailing Address - Fax:317-802-9911
Practice Address - Street 1:8091 TOWNSHIP LINE RD
Practice Address - Street 2:STE 109
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260
Practice Address - Country:US
Practice Address - Phone:317-802-9900
Practice Address - Fax:317-802-9911
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01051162A208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200241710BMedicaid
IN340019988OtherRR MEDICARE
IN000000203187OtherANTHEM BCBS
IN200241710BMedicaid
IN000000203187OtherANTHEM BCBS