Provider Demographics
NPI:1801943477
Name:SHUGERMAN, EARLE (MD)
Entity type:Individual
Prefix:DR
First Name:EARLE
Middle Name:
Last Name:SHUGERMAN
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 1:2501 WALNUT ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5751
Mailing Address - Country:US
Mailing Address - Phone:303-447-1570
Mailing Address - Fax:303-442-1125
Practice Address - Street 1:2501 WALNUT ST
Practice Address - Street 2:SUITE 206
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5751
Practice Address - Country:US
Practice Address - Phone:303-447-1570
Practice Address - Fax:303-442-1125
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry