Healthcare Provider Details

I. General information

NPI: 1477596708
Provider Name (Legal Business Name): HUGH E MIGHTY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 GEORGIA AVE NW TOWERS BUILDING RM 6010
WASHINGTON DC
20060-1734
US

IV. Provider business mailing address

2041 GEORGIA AVE NW TOWERS BUILDING RM 6010
WASHINGTON DC
20060-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-2625
  • Fax:
Mailing address:
  • Phone: 202-865-2625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD28381
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberD28381
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberMD043602
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: