Individual
RAEFORD THEODORE PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 277-1800
(336) 277-6981
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 277-1800
(336) 277-6981
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
33291
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8969438
—
NC
Enumeration date
03/24/2006
Last updated
10/25/2020
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