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General NPI Number Information
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NPI Number | 1548458904
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Entity Type | Organization
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Legal Business Name | DOUGLAS E. PUGMIRE DO PLLC
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 1515 LAKE LANSING RD SUITE O
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City | LANSING
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State | MI
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Zip | 48912-3753
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Country | US
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Telephone | 517-372-9967
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Fax | 517-372-0669
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Provider Business Mailing Address
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Address Line | 1515 LAKE LANSING RD SUITE O
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City | LANSING
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State | MI
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Zip | 48912-3753
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Country | US
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Telephone | 517-372-9967
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Fax | 517-372-0669
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Authorized Official
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Title or Position | OWNER
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Name | DR. DOUGLAS E PUGMIRE
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Credential | D.O.
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Telephone | 517-372-9967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 5101013693
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License Number State | MI
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