Provider Demographics
NPI:1538158670
Name:DUGGAN, ROBERT (DPM)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:DUGGAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 N WESTMONTE DR
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3345
Mailing Address - Country:US
Mailing Address - Phone:407-389-5300
Mailing Address - Fax:407-389-5363
Practice Address - Street 1:401 MULBERRY ST SW STE 102
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645
Practice Address - Country:US
Practice Address - Phone:828-757-6434
Practice Address - Fax:828-757-6435
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO2277213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340569900Medicaid
FL5437720002Medicare NSC
FL65254VMedicare PIN
FL65254WMedicare PIN
T19322Medicare UPIN
FL5437720001Medicare NSC