Individual
JAKE DUGGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3326
Mailing address
3500 N BROAD STREET, 001A, PHILADELPHIA, PA 19140-5103
(215) 707-3411
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD478587
PA
207L00000X
Anesthesiology Physician
MT215705
PA
Other
Enumeration date
06/12/2018
Last updated
08/03/2022
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