Provider Demographics
NPI:1669702387
Name:DUGAN, CHRISTOPHER L (CRNA)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:L
Last Name:DUGAN
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:PO BOX 32861
Mailing Address - Street 2:ANESTHESIA SERVICES - 5TH FLOOR SURGICAL TOWER
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28232-2861
Mailing Address - Country:US
Mailing Address - Phone:704-355-8983
Mailing Address - Fax:704-355-7938
Practice Address - Street 1:1000 BLYTHE BLVD
Practice Address - Street 2:ANESTHESIA SERVICES-5TH FLOOR SURGICAL TOWER
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5812
Practice Address - Country:US
Practice Address - Phone:704-355-8983
Practice Address - Fax:704-355-7938
Is Sole Proprietor?:No
Enumeration Date:2009-12-31
Last Update Date:2011-07-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC171167367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8053719Medicaid
SCNAN944Medicaid
NC2618326Medicare PIN
NC8053719Medicaid