Provider Demographics
NPI:1134193733
Name:DUGAN, ELIZABETH MITCHELL (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MITCHELL
Last Name:DUGAN
Suffix:
Gender:F
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:PO BOX 42096
Mailing Address - Street 2:USPS NORTHWEST STATION
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-0696
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10313 GEORGIA AVE
Practice Address - Street 2:STE. 309
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5006
Practice Address - Country:US
Practice Address - Phone:301-681-3442
Practice Address - Fax:301-330-6300
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0038251207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCP00773622OtherRAILROAD MEDICARE
F61582Medicare UPIN
DCP00773622OtherRAILROAD MEDICARE
MDG02081Medicare PIN