Provider Demographics
NPI:1982610382
Name:SUGAR, MARK H (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:H
Last Name:SUGAR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6505 BELCREST RD
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-2011
Mailing Address - Country:US
Mailing Address - Phone:301-699-5900
Mailing Address - Fax:301-699-9297
Practice Address - Street 1:6505 BELCREST RD
Practice Address - Street 2:SUITE ONE
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-2011
Practice Address - Country:US
Practice Address - Phone:301-699-5900
Practice Address - Fax:301-699-9297
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD355213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6170110001Medicare NSC
MDT30837Medicare UPIN
MD067365Medicare ID - Type Unspecified