Provider Demographics
NPI:1487660999
Name:DUGGAN, PATRICIA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:DUGGAN
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 1:730 SOM CENTER RD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44143-2350
Mailing Address - Country:US
Mailing Address - Phone:440-442-9300
Mailing Address - Fax:440-442-9308
Practice Address - Street 1:730 SOM CENTER RD
Practice Address - Street 2:SUITE 170
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44143-2350
Practice Address - Country:US
Practice Address - Phone:440-442-9300
Practice Address - Fax:440-442-9308
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0835622086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH200087072028OtherCARESOURCE
OHP00301999OtherRAILROAD MEDICARE
OH2434539Medicaid
OHH98048Medicare UPIN
OHDU4121454Medicare ID - Type UnspecifiedMEDICARE NUMBER