Healthcare Provider Details

I. General information

NPI: 1427059526
Provider Name (Legal Business Name): MARK ANDREW HUGHES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 03/02/2022
Certification Date: 11/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 6TH AVE
HUNTINGTON WV
25701-2312
US

IV. Provider business mailing address

1230 6TH AVE
HUNTINGTON WV
25701-2312
US

V. Phone/Fax

Practice location:
  • Phone: 304-526-9111
  • Fax: 304-526-9140
Mailing address:
  • Phone: 304-526-9111
  • Fax: 304-526-9140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number18134
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number18134
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: