Doctor Name: | MRS. MARTINA A PUGH |
NPI Number: | 1235469081 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | ARNP 9297927 |
Business Practice Address: | 6514 Meadowridge Rd Elkridge, MD - 210756115 |
Business Phone Number: | 4103822823 |
Business Fax Number: | |
Mailing Address: | 6514 Meadowridge Rd, ELKRIDGE |
State: | MD |
Postal Code: | 210756115 |
Phone Number: | 4103822823 |
Fax Number: | |
NPI Enumeration Date: | 12/29/2009 |
NPI Last Update Date: | 07/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LG0600X |
License Number: | ARNP 9297927 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Gerontology |
Taxonomy Definition: |