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1750351748

NPI Code Detail

MEDICARE: DR. MICHAEL J MACUGA MD

MEDICARE: DR. MICHAEL J MACUGA MD

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	207P00000X	Emergency Medicine Physician	01040789A	IN
2	207P00000X	Emergency Medicine Physician	ME99841	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	930115712	OTHER	IN	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME99841	OTHER	FL	MEDICAL LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	90001082	OTHER	IL	BCBS
5	000000223685	OTHER	IN	ANTHEM BCBS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750351748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL J MACUGA MD

Provider Business Mailing Address
First Line	:	3393 SUNSET KEY CIR
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33955-1971
Country	:	US
Telephone Number	:	219-776-7708
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 HARBOR BLVD
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-5000
Country	:	US
Telephone Number	:	941-766-4122
Fax Number	:

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

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	04/14/2021

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Directions to “ DR. MICHAEL J MACUGA MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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