Provider Demographics
NPI:1902854367
Name:DUGAN, ROBERT B (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:DUGAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 W 38TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-2531
Mailing Address - Country:US
Mailing Address - Phone:814-866-1960
Mailing Address - Fax:814-866-1935
Practice Address - Street 1:926 W 38TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-2531
Practice Address - Country:US
Practice Address - Phone:814-866-1960
Practice Address - Fax:814-866-1935
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009851L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA155790OtherHEALTH AMERICA
PA039899OtherHIGHMARK BC/BS
PA1510251OtherGATEWAY
PA0017226550003Medicaid
PA210832OtherUPMC
PA39D0999420OtherCLIA NUMBER
PAG83555Medicare UPIN
PA080154517Medicare PIN
PA021565Medicare PIN
PA39D0999420OtherCLIA NUMBER