Provider Demographics
NPI:1225093248
Name:DAVID-HUGUES, MICHELLE DAWN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:DAWN
Last Name:DAVID-HUGUES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2258 PULLMAN WAY
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-6826
Mailing Address - Country:US
Mailing Address - Phone:717-782-5223
Mailing Address - Fax:717-782-5865
Practice Address - Street 1:111 S FRONT ST
Practice Address - Street 2:NICU, 8TH FLOOR
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101-2010
Practice Address - Country:US
Practice Address - Phone:717-782-3127
Practice Address - Fax:717-782-3143
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD071267L2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013013060001Medicaid