MEDICARE: DR. DARREN KLUGMAN MD, MMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0203X	Pediatric Critical Care Medicine Physician	D89740	MD
2	2080P0203X	Pediatric Critical Care Medicine Physician	MD034992	DC
3	2080P0202X	Pediatric Cardiology Physician	D89740	MD

General Provider Information

NPI Number	:	1003942475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARREN KLUGMAN MD, MMS

Provider Business Mailing Address
First Line	:	2024 WEST ST STE 304
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-3556
Country	:	US
Telephone Number	:	443-598-2480
Fax Number	:	443-598-2488

Provider Business Practice Location Address
First Line	:	2024 WEST ST STE 304
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-3556
Country	:	US
Telephone Number	:	443-598-2480
Fax Number	:	443-598-2488

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	02/03/2026

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