Provider Demographics
NPI:1932141991
Name:DUGAN, PATRICK P (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:P
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 1:604 ANN ST
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-5122
Mailing Address - Country:US
Mailing Address - Phone:304-424-4593
Mailing Address - Fax:304-424-4017
Practice Address - Street 1:604 ANN ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-5122
Practice Address - Country:US
Practice Address - Phone:304-865-5155
Practice Address - Fax:304-865-5156
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20069208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV340017849OtherRAILROAD MEDICARE
WV007479117OtherAETNA
OH2298704Medicaid
WV001720892OtherBLUE CROSS BLUE SHIELD
WV7500043000Medicaid
WV007479117OtherAETNA
WV4015661Medicare ID - Type Unspecified
OH2298704Medicaid