Provider Demographics
NPI:1023181955
Name:HUG, GERALD AUGUST JR (MA CCC A)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:AUGUST
Last Name:HUG
Suffix:JR
Gender:M
Credentials:MA CCC A
Other - Prefix:
Other - First Name:GERALD
Other - Middle Name:
Other - Last Name:HUG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA CCC A
Mailing Address - Street 1:705 S MAIN ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-2089
Mailing Address - Country:US
Mailing Address - Phone:734-451-0800
Mailing Address - Fax:734-451-0813
Practice Address - Street 1:705 S MAIN ST
Practice Address - Street 2:SUITE 205
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-2089
Practice Address - Country:US
Practice Address - Phone:734-451-0800
Practice Address - Fax:734-451-0813
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000233231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI540H208620OtherBCBS OF MI
MI640F326550OtherBCBS OF MI
MI640F326550OtherBCBS OF MI
MI540H208620OtherBCBS OF MI