MEDICARE: DR. MICHAEL BRADFORD HUGGINS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	30268	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	2335816	OTHER	NC	MEDICARE PTAN, GROUP
3	P00630485	OTHER	NC	RR MEDICARE
4	207426B	OTHER	NC	MEDICARE PTAN, INDIVIDUAL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104894955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL BRADFORD HUGGINS M.D.

Provider Business Mailing Address
First Line	:	1915 W PARK DR
Second Line	:	SUITE 101
City	:	NORTH WILKESBORO
State	:	NC
Zip	:	28659-3777
Country	:	US
Telephone Number	:	336-651-8700
Fax Number	:	336-651-8710

Provider Business Practice Location Address
First Line	:	1915 W PARK DR
Second Line	:	SUITE 101
City	:	NORTH WILKESBORO
State	:	NC
Zip	:	28659-3777
Country	:	US
Telephone Number	:	336-651-8700
Fax Number	:	336-651-8710

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	06/20/2011

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Directions to “ DR. MICHAEL BRADFORD HUGGINS M.D.” Practice Location

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