Provider Demographics
NPI:1235134628
Name:HUGHES, KERN MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:KERN
Middle Name:MICHAEL
Last Name:HUGHES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:25 MONUMENT RD
Practice Address - Street 2:SUITE 120
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5049
Practice Address - Country:US
Practice Address - Phone:717-851-6110
Practice Address - Fax:717-851-1999
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2003-00997208600000X
PAOS006127L2086S0102X, 2086S0127X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1034988OtherGATEWAY-WMG
MD956449OtherCAREFIRST MD BCBS
PA20093560OtherAMERIHEALTH MERCY-WMG
PA008387OtherHIGHMARK BLUE SHIELD
PA001426602Medicaid
MD037472500Medicaid
PAP00883459Medicare PIN
NCA82371Medicare UPIN
PA001426602Medicaid