Healthcare Provider Details

I. General information

NPI: 1043250822
Provider Name (Legal Business Name): MAGDA EL RAHEB PUGH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10010 FALLS OF NEUSE SUITE 012
RALEIGH NC
27614
US

IV. Provider business mailing address

2920 HIGHWOODS BLVD
RALEIGH NC
27604-0010
US

V. Phone/Fax

Practice location:
  • Phone: 919-766-8989
  • Fax: 919-766-8896
Mailing address:
  • Phone: 877-498-4490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number38171
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: