Provider Demographics
NPI:1346354529
Name:SUGAR, SAM J (MD)
Entity Type:Individual
Prefix:DR
First Name:SAM
Middle Name:J
Last Name:SUGAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5630 OAKTREE AVE
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312
Mailing Address - Country:US
Mailing Address - Phone:954-613-5740
Mailing Address - Fax:954-613-5668
Practice Address - Street 1:5630 OAKTREE AVE
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312
Practice Address - Country:US
Practice Address - Phone:954-613-5740
Practice Address - Fax:954-613-5668
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME81368207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU1796AMedicare ID - Type Unspecified