Healthcare Provider Details

I. General information

NPI: 1255821237
Provider Name (Legal Business Name): JOHN DUGGAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 07/05/2024
Certification Date: 07/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GENERAL SURGERY RESIDENCY PROGRAM, WALTER REED NMMC 8901 WISCONSIN AVE
BETHESDA MD
20889-0004
US

IV. Provider business mailing address

GENERAL SURGERY RESIDENCY PROGRAM, WALTER REED NMMC 8901 WISCONSIN AVE
BETHESDA MD
20889-0004
US

V. Phone/Fax

Practice location:
  • Phone: 301-400-2185
  • Fax:
Mailing address:
  • Phone: 301-400-2185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101268287
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: