Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 38171 | NC |
NPI | 1043250822 |
---|---|
Provider Name | Magda El Raheb Pugh |
First Address | Raleigh, NC 27604-0010 |
Second Address | Raleigh, NC 27614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 31/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C29188 | (02) | NC |