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Individual

ROBERT DAVID PUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
775 E 200 N, OREM, UT 84097-4953
(801) 633-5416
Mailing address
775 E 200 N, OREM, UT 84097-4953
(801) 633-5416

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
5494787-3102
UT
163WC0200X
Critical Care Medicine Registered Nurse
310189
NC
367500000X
Certified Registered Nurse Anesthetist
0000000-0000
UT
367500000X
Certified Registered Nurse Anesthetist
Primary
202211571CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
6543
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000000
NONE
Enumeration date
11/16/2020
Last updated
10/28/2022
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