Individual
DR. JOHN E PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
491 PEACH RD, EPHRATA, PA 17522
(717) 606-7652
(717) 336-4014
Mailing address
1025 S COCALICO RD, DENVER, PA 17517-9545
(717) 606-7652
(717) 336-4014
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS-006830L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018870100002
—
PA
01
—
1548470
GATEWAY MEDICARE ASSURED
PA
01
—
383875
VALUE OPTIONS
PA
Enumeration date
11/06/2006
Last updated
07/08/2007
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