Healthcare Provider Details

I. General information

NPI: 1477511152
Provider Name (Legal Business Name): BUCHANAN MERRYMAN DUGAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 04/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 GORMAN AVE STE 103
ELKINS WV
26241
US

IV. Provider business mailing address

725 NORTH ST
PITTSFIELD MA
01201
US

V. Phone/Fax

Practice location:
  • Phone: 304-637-9302
  • Fax: 304-637-9306
Mailing address:
  • Phone: 413-447-2752
  • Fax: 413-496-6836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number226382
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: