Healthcare Provider Details

I. General information

NPI: 1710507686
Provider Name (Legal Business Name): CONNOR DUGAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2020
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 EXECUTIVE DR STE 111
RALEIGH NC
27609-7445
US

IV. Provider business mailing address

3320 EXECUTIVE DR STE 111
RALEIGH NC
27609-7445
US

V. Phone/Fax

Practice location:
  • Phone: 919-876-2427
  • Fax: 919-850-9234
Mailing address:
  • Phone: 919-876-2427
  • Fax: 919-850-9234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number2024-03194
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: