Provider Demographics
NPI:1528006889
Name:DUGAN, KAREN MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MICHELLE
Last Name:DUGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1348 MARBLE CREST WAY
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4656
Mailing Address - Country:US
Mailing Address - Phone:240-285-5756
Mailing Address - Fax:
Practice Address - Street 1:1348 MARBLE CREST WAY
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4656
Practice Address - Country:US
Practice Address - Phone:240-285-5756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD52881207L00000X
FLME144735207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
601285800OtherFECA
MD801000500Medicaid
MD839MK232Medicare ID - Type UnspecifiedMD MEDICARE GROUP 839M
MD015651F85Medicare ID - Type UnspecifiedMD MEDICARE GROUP G01485
MD801000500Medicaid