Healthcare Provider Details

I. General information

NPI: 1528205564
Provider Name (Legal Business Name): JOSHUA MICHAEL DUGGAN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2009
Last Update Date: 10/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 NH ROUTE 108 SUITE B
DOVER NH
03820
US

IV. Provider business mailing address

158 NH ROUTE 108 SUITE B
DOVER NH
03820
US

V. Phone/Fax

Practice location:
  • Phone: 603-742-6555
  • Fax: 603-742-2908
Mailing address:
  • Phone: 603-742-6555
  • Fax: 603-742-2908

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number012928
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: