Individual
DR. GREGORY E PUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2015 JACKSON ST, ANDERSON, IN 46016-4337
(765) 646-8243
(765) 646-8655
Mailing address
2015 JACKSON ST, ANDERSON, IN 46016-4337
(765) 646-8243
(765) 646-8655
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
01050276A
IN
207P00000X
Emergency Medicine Physician
Primary
01050276A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000807474
ANTHEM
IN
05
—
200242240
—
IN
01
—
930126123
MEDICARE RR
IN
Enumeration date
06/17/2005
Last updated
11/15/2016
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