Provider Demographics
NPI:1760684856
Name:DUGAN, NIELS ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:NIELS
Middle Name:ROBERT
Last Name:DUGAN
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 1:5770 EAGLESRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-1386
Mailing Address - Country:US
Mailing Address - Phone:513-231-2445
Mailing Address - Fax:
Practice Address - Street 1:PMG HOSPITALIST GROUP
Practice Address - Street 2:1100 CENTRAL AV SE
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106
Practice Address - Country:US
Practice Address - Phone:505-724-6124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2000-179207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208M00000XAllopathic & Osteopathic PhysiciansHospitalist