Individual
TREVOR C. PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1160 KEPLER DR, GREEN BAY, WI 54311-8321
(833) 986-2170
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
11899060-1204
UT
2083X0100X
Occupational Medicine Physician
Primary
22534
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100205995
—
WI
Enumeration date
03/20/2017
Last updated
07/14/2025
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