Provider Demographics
NPI:1659559177
Name:PAUL J. DUGGAN, M.D. P.C.
Entity Type:Organization
Organization Name:PAUL J. DUGGAN, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-331-3100
Mailing Address - Street 1:851 MAIN ST
Mailing Address - Street 2:SUITE 25
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1612
Mailing Address - Country:US
Mailing Address - Phone:781-331-3100
Mailing Address - Fax:781-331-3101
Practice Address - Street 1:851 MAIN ST
Practice Address - Street 2:SUITE 25
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1612
Practice Address - Country:US
Practice Address - Phone:781-331-3100
Practice Address - Fax:781-331-3101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA28582207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA65768Medicare UPIN