Provider Demographics
NPI:1952595571
Name:DUGAN, GIRARD F (NP)
Entity Type:Individual
Prefix:
First Name:GIRARD
Middle Name:F
Last Name:DUGAN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 CHESTNUT STREET
Mailing Address - Street 2:2ND FL
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5000
Mailing Address - Fax:
Practice Address - Street 1:115 WEST SILVER STREET
Practice Address - Street 2:2ND FL
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-3678
Practice Address - Country:US
Practice Address - Phone:413-572-6063
Practice Address - Fax:413-562-4975
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006366363L00000X, 363LA2200X
MARN192151363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000281701Medicare PIN
P00449516Medicare PIN