Provider Demographics
NPI:1477677284
Name:SHUGARMAN, RYAN S (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:S
Last Name:SHUGARMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RYAN
Other - Middle Name:SCOTT
Other - Last Name:SHUGARMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:901 N WASHINGTON ST
Mailing Address - Street 2:SUITE 601
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-1535
Mailing Address - Country:US
Mailing Address - Phone:703-596-1024
Mailing Address - Fax:703-596-1573
Practice Address - Street 1:901 N WASHINGTON ST STE 601
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1535
Practice Address - Country:US
Practice Address - Phone:703-596-1024
Practice Address - Fax:703-596-1573
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD0378012084F0202X, 2084P0800X
MDD00686412084F0202X, 2084P0800X
VA01012450802084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC261356YLR5Medicare PIN