Individual
CHARLES J SUGARMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
525 ALEXANDRIA PIKE, SUITE 230, SOUTHGATE, KY 41071-3290
(859) 441-4334
(859) 441-3698
Mailing address
2300 CHAMBER CENTER DR, LAKESIDE PARK, KY 41017-1686
(859) 441-4334
(859) 441-3698
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
00170
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000033161
ANTHEM
KY
01
—
27-00336
UHC
KY
01
—
4491387
AETNA
KY
05
—
80001704
—
KY
05
—
90260191
—
KY
Enumeration date
07/18/2005
Last updated
04/26/2017
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