Provider Demographics
NPI:1366743486
Name:DUGAN, THOMAS MARTIN (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MARTIN
Last Name:DUGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4673 RUE BELLE MER
Mailing Address - Street 2:
Mailing Address - City:SANIBEL
Mailing Address - State:FL
Mailing Address - Zip Code:33957-2707
Mailing Address - Country:US
Mailing Address - Phone:239-395-1078
Mailing Address - Fax:239-395-1078
Practice Address - Street 1:4673 RUE BELLE MER
Practice Address - Street 2:
Practice Address - City:SANIBEL
Practice Address - State:FL
Practice Address - Zip Code:33957-2707
Practice Address - Country:US
Practice Address - Phone:239-395-1078
Practice Address - Fax:239-395-1078
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL90469207RC0000X
PAMD016880E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease