Individual
PEGGY ANN PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G57720
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G577200
BLUE SHIELD OF CA
—
05
—
00G577200
—
CA
01
—
00G577200Q92
CALOPTIMA
—
05
—
1518966902
—
CA
01
—
300123286
RAILROAD MEDICARE
—
Enumeration date
07/18/2005
Last updated
06/13/2012
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