Healthcare Provider Details

I. General information

NPI: 1003801754
Provider Name (Legal Business Name): M STEVEN HUGHES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1632 116TH AVE NE STE C
BELLEVUE WA
98004-3035
US

IV. Provider business mailing address

1632 116TH AVE NE STE C
BELLEVUE WA
98004-3035
US

V. Phone/Fax

Practice location:
  • Phone: 425-452-1453
  • Fax: 425-453-5058
Mailing address:
  • Phone: 425-452-1453
  • Fax: 425-453-5058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD00027244
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: