Healthcare Provider Details

I. General information

NPI: 1659614972
Provider Name (Legal Business Name): COLIN MICHAEL MCHUGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2013
Last Update Date: 07/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SOUTH AVE BLDG LEVEL3
ROCHESTER NY
14620-2733
US

IV. Provider business mailing address

211 WHITE SPRUCE BLVD
ROCHESTER NY
14623-1618
US

V. Phone/Fax

Practice location:
  • Phone: 585-475-9411
  • Fax:
Mailing address:
  • Phone: 585-475-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number298961
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number298961
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: