Provider Demographics
NPI:1821020900
Name:LUGAR, OWEN
Entity Type:Individual
Prefix:DR
First Name:OWEN
Middle Name:
Last Name:LUGAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 WEST ROCKLAND ROAD
Mailing Address - Street 2:
Mailing Address - City:MONTCHANIN
Mailing Address - State:DE
Mailing Address - Zip Code:19710-0695
Mailing Address - Country:US
Mailing Address - Phone:302-656-0819
Mailing Address - Fax:302-656-0812
Practice Address - Street 1:457 WEST ROCKLAND ROAD
Practice Address - Street 2:
Practice Address - City:MONTCHANIN
Practice Address - State:DE
Practice Address - Zip Code:19710-0695
Practice Address - Country:US
Practice Address - Phone:302-656-0819
Practice Address - Fax:302-656-0812
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000073103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist