Provider Demographics
NPI:1336140367
Name:HUGHES, LISA M (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:HUGHES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:COPPULA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1307 FEDERAL ST STE B200
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4762
Mailing Address - Country:US
Mailing Address - Phone:412-322-4545
Mailing Address - Fax:412-322-4546
Practice Address - Street 1:1307 FEDERAL ST STE B200
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4762
Practice Address - Country:US
Practice Address - Phone:412-322-4545
Practice Address - Fax:412-322-4546
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD067871L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2341700Medicaid
PA001804358Medicaid
PAH16479Medicare UPIN
038100Medicare PIN
PA038100QURMedicare PIN