Provider Demographics
NPI:1346203015
Name:ZUG, MICHAEL S (MS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:ZUG
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1677
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 S FRONT ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1619
Practice Address - Country:US
Practice Address - Phone:717-231-8360
Practice Address - Fax:717-231-8358
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000835101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2102484OtherFIRST HEALTH
PA03155901OtherBLUE CROSS/CAIC
PA7303577OtherAETNA
PAPC000835OtherSTATE LICENSE