MEDICARE: DR. ANDREA DUGAS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	232169	MA
2	207P00000X	Emergency Medicine Physician	D70380	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316184609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA DUGAS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 64362
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21264-4362
Country	:	US
Telephone Number	:	301-631-8117
Fax Number	:

Provider Business Practice Location Address
First Line	:	5801 SMITH AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21209-3652
Country	:	US
Telephone Number	:	410-735-6400
Fax Number	:	410-735-6425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2009
Last Update Date	:	01/31/2011

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