Provider Demographics
NPI:1780403394
Name:SAM J SUGAR MD FACP
Entity type:Organization
Organization Name:SAM J SUGAR MD FACP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:SUGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-571-4323
Mailing Address - Street 1:5630 OAKTREE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-6375
Mailing Address - Country:US
Mailing Address - Phone:847-571-4323
Mailing Address - Fax:
Practice Address - Street 1:5630 OAKTREE AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-6375
Practice Address - Country:US
Practice Address - Phone:847-571-4323
Practice Address - Fax:847-571-4323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty