Provider Demographics
NPI:1760462725
Name:DUGOM, MUIN MOUSA (MD, FACP)
Entity Type:Individual
Prefix:DR
First Name:MUIN
Middle Name:MOUSA
Last Name:DUGOM
Suffix:
Gender:M
Credentials:MD, FACP
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Mailing Address - Street 1:2400 WAYNE MEMORIAL DR STE J
Mailing Address - Street 2:GOLDSBORO MEDICAL CENTER
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-1749
Mailing Address - Country:US
Mailing Address - Phone:919-739-9599
Mailing Address - Fax:919-739-5535
Practice Address - Street 1:2400 WAYNE MEMORIAL DR STE J
Practice Address - Street 2:GOLDSBORO MEDICAL CENTER
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1749
Practice Address - Country:US
Practice Address - Phone:919-739-9599
Practice Address - Fax:919-739-5535
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2016-01-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC9600902207R00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8929352Medicaid
NC147TCOtherBLUE CROSS
NC29352OtherBLUE CROSS
NC2228004CMedicare PIN
NC147TCOtherBLUE CROSS
NC8929352Medicaid
NC2228004BMedicare PIN