Provider Demographics
NPI:1982744173
Name:MARK SUGAR, DPM, LLC
Entity Type:Organization
Organization Name:MARK SUGAR, DPM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:H
Authorized Official - Last Name:SUGAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-699-5900
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD355213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty