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NPI Code Detail

MEDICARE: GENERAL PHYSICIAN SUB III PLLC

MEDICARE: GENERAL PHYSICIAN SUB III PLLC
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1932505419
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENERAL PHYSICIAN SUB III PLLC
Provider Business Mailing Address
First Line : PO BOX 8000 DEPARTMENT 540
Second Line :
City : BUFFALO
State : NY
Zip : 14267-0002
Country : US
Telephone Number : 203-944-1940
Fax Number : 203-402-4192
Provider Business Practice Location Address
First Line : 1430 COLVIN BLVD
Second Line :
City : BUFFALO
State : NY
Zip : 14223-1440
Country : US
Telephone Number : 716-874-4060
Fax Number : 716-874-0370
Authorized Official
Title or Position : OWNER
Name : DAVID HUGHES
Credential : MD
Telephone Number : 716-692-2160
Provider Enumeration Date : 11/12/2014
Last Update Date : 09/23/2019

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