Healthcare Provider Details

I. General information

NPI: 1083486997
Provider Name (Legal Business Name): SEAN HUGHES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 10/24/2023
Certification Date: 10/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 E HINES HILL RD
BOSTON HEIGHTS OH
44236-1118
US

IV. Provider business mailing address

4466 CHERRY ST SW
NEWTON FALLS OH
44444-9532
US

V. Phone/Fax

Practice location:
  • Phone: 330-543-8260
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZX2200X
TaxonomyOrthopedic Assistant
License Number19-0222
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: