MEDICARE: MR. ROGER HUGHES M.A. IN AUDIOLOGY

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	231H00000X	Audiologist	1601000104	MI

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	200000000506	OTHER	MI	PHPMM
4	640C312830	OTHER	MI	BCBSM

General Provider Information

NPI Number	:	1700934544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROGER HUGHES M.A. IN AUDIOLOGY

Provider Business Mailing Address
First Line	:	3410 BELLE CHASE WAY
Second Line	:	SUITE 700
City	:	LANSING
State	:	MI
Zip	:	48911-4274
Country	:	US
Telephone Number	:	517-887-7660
Fax Number	:	517-887-7661

Provider Business Practice Location Address
First Line	:	3410 BELLE CHASE WAY
Second Line	:	SUITE 700
City	:	LANSING
State	:	MI
Zip	:	48911-4274
Country	:	US
Telephone Number	:	517-887-7660
Fax Number	:	517-887-7661

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	01/03/2013

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