Individual
ROBERT M SHUGART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7601 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 436-8686
(260) 436-8585
Mailing address
PO BOX 2526, FORT WAYNE, IN 46801-2526
(260) 436-8686
(260) 436-8585
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01041990A
IN
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
01041990A
IN
207XS0117X
Orthopaedic Surgery of the Spine Physician
4301096712
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000089404
ANTHEM
—
05
—
100340210A
—
IN
01
—
200025156
RAILROAD MEDICARE
—
Enumeration date
05/24/2005
Last updated
11/07/2016
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