Provider Demographics
NPI:1275643561
Name:HUGHES, MARY DENISE (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:DENISE
Last Name:HUGHES
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:PO BOX 24217
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29616-4217
Mailing Address - Country:US
Mailing Address - Phone:864-421-4898
Mailing Address - Fax:864-655-4004
Practice Address - Street 1:420 THE PKWY STE N
Practice Address - Street 2:SUITE N
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-5205
Practice Address - Country:US
Practice Address - Phone:864-421-4898
Practice Address - Fax:864-655-4004
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2015-02572084N0400X
GA0426142084N0400X
SC305852084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00850150OtherRAILROAD MEDICARE
SCG42614Medicaid
G76832Medicare UPIN
SCP00850150OtherRAILROAD MEDICARE
SCAA37007951Medicare PIN
SCG42614Medicaid