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1861497463

NPI Code Detail

MEDICARE: MICHAEL JOSEPH SHUGAR MD

MEDICARE: MICHAEL JOSEPH SHUGAR 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	01057154A	IN
2	207P00000X	Emergency Medicine Physician	35072084	OH
3	207P00000X	Emergency Medicine Physician	16777	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	264430F05	OTHER	IN	MEDICARE

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861497463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL JOSEPH SHUGAR MD

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5165 MCCARTY LN
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47905-8764
Country	:	US
Telephone Number	:	765-448-8000
Fax Number	:	317-838-4751

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	08/22/2024

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Directions to “ MICHAEL JOSEPH SHUGAR 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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