MEDICARE: SAMUEL KELSE HUGHES 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	207Q00000X	Family Medicine Physician	2020-03033	NC

General Provider Information

NPI Number	:	1851825285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMUEL KELSE HUGHES M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1845
Second Line	:
City	:	STATESVILLE
State	:	NC
Zip	:	28687-1845
Country	:	US
Telephone Number	:	704-873-4277
Fax Number	:

Provider Business Practice Location Address
First Line	:	1424D FERN CREEK DR
Second Line	:
City	:	STATESVILLE
State	:	NC
Zip	:	28625-9376
Country	:	US
Telephone Number	:	704-872-0174
Fax Number	:	704-872-0176

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

Provider Enumeration Date	:	04/12/2017
Last Update Date	:	03/04/2026

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