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Individual
GAYLE MARIE PUGH
Active
Individual
GAYLE MARIE PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000495A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000340098
BLUE CROSS BLUE SHIELD
IN
01
—
264430E92
MEDICARE PTAN
IN
05
—
300018114
—
IN
Enumeration date
12/27/2006
Last updated
02/06/2024
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