Provider Demographics
NPI:1861497679
Name:SUGAR, ROBERT L (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:SUGAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8901 W 74TH ST
Mailing Address - Street 2:STE 248
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2202
Mailing Address - Country:US
Mailing Address - Phone:913-384-4990
Mailing Address - Fax:913-384-1310
Practice Address - Street 1:8901 W 74TH ST
Practice Address - Street 2:STE 248
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-2202
Practice Address - Country:US
Practice Address - Phone:913-384-4990
Practice Address - Fax:913-384-1310
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-14999207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4722558Medicare ID - Type Unspecified
C51715Medicare UPIN