Provider Demographics
NPI:1043250822
Name:PUGH, MAGDA EL RAHEB (MD)
Entity type:Individual
Prefix:
First Name:MAGDA
Middle Name:EL RAHEB
Last Name:PUGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2920 HIGHWOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-0010
Mailing Address - Country:US
Mailing Address - Phone:877-498-4490
Mailing Address - Fax:
Practice Address - Street 1:10010 FALLS OF NEUSE SUITE 012
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614
Practice Address - Country:US
Practice Address - Phone:919-766-8989
Practice Address - Fax:919-766-8896
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38171207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC29188Medicare UPIN