Provider Demographics
NPI:1063507754
Name:HUGHES, WARREN W (MSPT)
Entity Type:Individual
Prefix:MR
First Name:WARREN
Middle Name:W
Last Name:HUGHES
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 BEECHLAND ROAD
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605
Mailing Address - Country:US
Mailing Address - Phone:207-667-4800
Mailing Address - Fax:207-667-5600
Practice Address - Street 1:78 BEECHLAND ROAD
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605
Practice Address - Country:US
Practice Address - Phone:207-667-4800
Practice Address - Fax:207-667-5600
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT2544225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1063507754Medicaid
ME1063507754OtherCIGNA
ME1063507754OtherTRICARE
ME1063507754OtherHARVARD PILGRIM
ME1063507754OtherMEDICARE RAILROAD CARRIER
ME1063507754OtherAETNA
ME1063507754OtherANTHEM BLUE CROSS BLUE SHIELD
MEME0027Medicare ID - Type Unspecified
ME1063507754OtherANTHEM BLUE CROSS BLUE SHIELD