Healthcare Provider Details

I. General information

NPI: 1497731442
Provider Name (Legal Business Name): MICHAEL L HUGHES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 01/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1736 OLD YORK RD
YORK SC
29745-9458
US

IV. Provider business mailing address

102 REEDY ST
CHESTER SC
29706-1836
US

V. Phone/Fax

Practice location:
  • Phone: 803-818-6955
  • Fax: 803-818-6993
Mailing address:
  • Phone: 803-374-6409
  • Fax: 803-377-8021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086H0002X
TaxonomyHospice and Palliative Medicine (Surgery) Physician
License Number23667
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number23667
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: