Provider Demographics
NPI:1427048941
Name:SUGARBAKER, PAUL H (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:H
Last Name:SUGARBAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT 490
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20042-0001
Mailing Address - Country:US
Mailing Address - Phone:301-652-5771
Mailing Address - Fax:301-652-6332
Practice Address - Street 1:106 IRVING ST NW
Practice Address - Street 2:SUITE N-3900
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2927
Practice Address - Country:US
Practice Address - Phone:202-877-3908
Practice Address - Fax:202-877-8602
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD178962086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A66119Medicare UPIN
609685Medicare ID - Type Unspecified