Healthcare Provider Details

I. General information

NPI: 1134193733
Provider Name (Legal Business Name): ELIZABETH MITCHELL DUGAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 03/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10313 GEORGIA AVE STE. 309
SILVER SPRING MD
20902-5006
US

IV. Provider business mailing address

PO BOX 42096 USPS NORTHWEST STATION
WASHINGTON DC
20015-0696
US

V. Phone/Fax

Practice location:
  • Phone: 301-681-3442
  • Fax: 301-330-6300
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberD0038251
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: