Provider Demographics
NPI:1861525149
Name:DUGAN, CINDY CONSTANTINO (MD)
Entity type:Individual
Prefix:DR
First Name:CINDY
Middle Name:CONSTANTINO
Last Name:DUGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 WINDSOR DR.
Mailing Address - Street 2:
Mailing Address - City:MINERAL WELLS
Mailing Address - State:WV
Mailing Address - Zip Code:26150
Mailing Address - Country:US
Mailing Address - Phone:304-489-3067
Mailing Address - Fax:
Practice Address - Street 1:184 HOLIDAY HILLS DR
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-8006
Practice Address - Country:US
Practice Address - Phone:304-485-1721
Practice Address - Fax:304-485-6710
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV203222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV20322OtherMEDICAL LICENSE
WVBC5241752OtherDEA CERTIFICATE