Provider Demographics
NPI:1578344990
Name:PUGI, JAKOB (MD)
Entity Type:Individual
Prefix:
First Name:JAKOB
Middle Name:
Last Name:PUGI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 JACKSON STREET W
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:ON
Mailing Address - Zip Code:L8P1N4
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1280 MAIN ST W
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:ON
Practice Address - Zip Code:L8S 4L8
Practice Address - Country:CA
Practice Address - Phone:613-985-5896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ119163207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology