Individual
MR. GARY MICHAEL PUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPAS, PA-C, ATC
Contact information
Practice address
2800 IVY RD, CHARLOTTESVILLE, VA 22903
(434) 243-3600
(434) 244-4454
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0126000653
VA
363A00000X
Physician Assistant
Primary
0110004241
VA
Other
Enumeration date
05/08/2007
Last updated
08/09/2023
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