Provider Demographics
NPI:1710965496
Name:HUG, RUSSELL G (MD)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:G
Last Name:HUG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3290 W BIG BEAVER RD
Mailing Address - Street 2:STE 420
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084
Mailing Address - Country:US
Mailing Address - Phone:248-649-9700
Mailing Address - Fax:248-649-9745
Practice Address - Street 1:3290 W BIG BEAVER RD
Practice Address - Street 2:STE 420
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084
Practice Address - Country:US
Practice Address - Phone:248-649-9700
Practice Address - Fax:248-649-9745
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301056502207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0M15930Medicare ID - Type Unspecified
F59495Medicare UPIN