Healthcare Provider Details

I. General information

NPI: 1477975464
Provider Name (Legal Business Name): BRITTANY DZUGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2014
Last Update Date: 01/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DRIVE PHYSICIAN OFFICE CENTER/ WVU HOSPITAL'S INC
MORGANTOWN WV
26507
US

IV. Provider business mailing address

1012 LONGVUE AVE
ALIQUIPPA PA
15001-4515
US

V. Phone/Fax

Practice location:
  • Phone: 304-293-3908
  • Fax:
Mailing address:
  • Phone: 724-622-9049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: