Provider Demographics
NPI:1497731442
Name:HUGHES, MICHAEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
Last Name:HUGHES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 REEDY ST
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:SC
Mailing Address - Zip Code:29706-1836
Mailing Address - Country:US
Mailing Address - Phone:803-374-6409
Mailing Address - Fax:803-377-8021
Practice Address - Street 1:1736 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:SC
Practice Address - Zip Code:29745-9458
Practice Address - Country:US
Practice Address - Phone:803-818-6955
Practice Address - Fax:803-818-6993
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2018-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC236672086H0002X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2086H0002XAllopathic & Osteopathic PhysiciansSurgeryHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC236676Medicaid
SCH44180Medicare UPIN
SCH441807587Medicare ID - Type Unspecified