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NPI Code Detail

MEDICARE: DR. KEVIN PATRICK DUGAN PHD, HSPP

MEDICARE: DR. KEVIN PATRICK DUGAN PHD, HSPP
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
1103TC1900XCounseling Psychologist20041836AIN

General Provider Information

NPI Number : 1548256795
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN PATRICK DUGAN PHD, HSPP
Provider Business Mailing Address
First Line : 10293 N MERIDIAN ST
Second Line : SUITE 375
City : INDIANAPOLIS
State : IN
Zip : 46290-1123
Country : US
Telephone Number : 317-581-2288
Fax Number :
Provider Business Practice Location Address
First Line : 10293 N MERIDIAN ST
Second Line : SUITE 375
City : INDIANAPOLIS
State : IN
Zip : 46290-1123
Country : US
Telephone Number : 317-581-2288
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 03/24/2008

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