Provider Demographics
NPI:1477897288
Name:DUGGAN, AMY SUZANNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:SUZANNE
Last Name:DUGGAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:SUZANNE
Other - Last Name:MOTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1462 MONTREAL RD
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-6929
Mailing Address - Country:US
Mailing Address - Phone:770-934-0000
Mailing Address - Fax:770-934-0002
Practice Address - Street 1:1462 MONTREAL RD
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-6929
Practice Address - Country:US
Practice Address - Phone:770-934-0000
Practice Address - Fax:770-934-0002
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022453183500000X
NV16630183500000X
CO18592183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist