Provider Demographics
NPI:1154378818
Name:PUGH, GUY F (MD)
Entity type:Individual
Prefix:
First Name:GUY
Middle Name:F
Last Name:PUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-1628
Mailing Address - Country:US
Mailing Address - Phone:617-661-6225
Mailing Address - Fax:
Practice Address - Street 1:2500 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-1628
Practice Address - Country:US
Practice Address - Phone:617-661-6225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74592207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5351436OtherAETNA
MAJ17048OtherBCBS OF MA
MAB20420801OtherCIGNA
MA66468OtherHARVARD PILGRIM
MA751391OtherTUFTS HEALTH PLAN
MA0402649OtherUNITED HEALTH CARE
MAA21553Medicare ID - Type UnspecifiedMEDICARE
MA66468OtherHARVARD PILGRIM