Individual
DR. STUART RONALD SUGARMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 E BROADWAY, SUITE 220, JACKSON, WY 83001
(307) 734-8800
(307) 734-8900
Mailing address
P O BOX 15540, JACKSON, WY 83002
(307) 734-8800
(307) 734-8900
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5801A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111551100
—
WY
Enumeration date
11/09/2006
Last updated
07/08/2007
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