Provider Demographics
NPI:1134758329
Name:SUGAR, DAVIS ANDREW (MD)
Entity type:Individual
Prefix:MR
First Name:DAVIS
Middle Name:ANDREW
Last Name:SUGAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10 EMERALD HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:STOUFFVILLE
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:LAG 187
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 RIVERSIDE CIRCLE, SUITE 401, ROANOKE, VA, 24016
Practice Address - Street 2:SUITE 401
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016
Practice Address - Country:US
Practice Address - Phone:540-981-8247
Practice Address - Fax:540-266-5843
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program