Provider Demographics
NPI:1215765912
Name:MCGUGIN, CHASE
Entity type:Individual
Prefix:MR
First Name:CHASE
Middle Name:
Last Name:MCGUGIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:OH
Mailing Address - Zip Code:44875-1439
Mailing Address - Country:US
Mailing Address - Phone:419-526-5437
Mailing Address - Fax:
Practice Address - Street 1:147 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:OH
Practice Address - Zip Code:44875-1439
Practice Address - Country:US
Practice Address - Phone:419-526-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator