Provider Demographics
NPI:1538102686
Name:DUGGAL, MANVEEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MANVEEN
Middle Name:
Last Name:DUGGAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WOLF CREEK BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-4969
Mailing Address - Country:US
Mailing Address - Phone:302-734-2782
Mailing Address - Fax:302-734-2784
Practice Address - Street 1:111 WOLF CREEK BLVD STE 3
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4969
Practice Address - Country:US
Practice Address - Phone:302-734-2782
Practice Address - Fax:302-734-2784
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1 0005520207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEH09157Medicare UPIN