Active NPI
Cameron Pugach
- Student in an Organized Health Care Education/Training Program
- Greensboro, NC
National Provider Identifier
1720753544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 5906
- Practice address
- 1100 W Market St FL 2
Greensboro, NC 27403-1830 - Phone
- (336) 334-5662
- Fax
- (336) 334-5754
- NPI assigned
- Aug 13, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 5906 | NC | Primary |
Addresses
Primary practice location
1100 W Market St FL 2
Greensboro, NC 27403-1830
Mailing address
1100 W Market St FL 2
Greensboro, NC 27403-1830
Phone (336) 334-3453
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5906 | NC | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633564800000",
"number": "1720753544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 W MARKET ST FL 2",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274031830",
"telephone_number": "336-334-3453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 W MARKET ST FL 2",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274031830",
"telephone_number": "336-334-5662",
"fax_number": "336-334-5754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUGACH",
"first_name": "CAMERON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-13",
"last_updated": "2021-10-07",
"certification_date": "2021-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NC",
"license": "5906",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.