Provider Demographics
NPI:1629018130
Name:DUGGAL, ASHWANI (MD)
Entity Type:Individual
Prefix:
First Name:ASHWANI
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 1:1 CAYLOR NICKEL SQ
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-2529
Mailing Address - Country:US
Mailing Address - Phone:260-824-3500
Mailing Address - Fax:260-919-3419
Practice Address - Street 1:1 CAYLOR NICKEL SQ
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-2529
Practice Address - Country:US
Practice Address - Phone:260-824-3500
Practice Address - Fax:260-919-3419
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01047610A207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G64865Medicare UPIN
IN912030BMedicare PIN