Provider Demographics
NPI:1538113428
Name:HUGHES, DOREEN LOUISE (MD)
Entity Type:Individual
Prefix:MS
First Name:DOREEN
Middle Name:LOUISE
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 1:112 S SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-3767
Mailing Address - Country:US
Mailing Address - Phone:336-724-0101
Mailing Address - Fax:336-724-2241
Practice Address - Street 1:112 S SPRUCE ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-3767
Practice Address - Country:US
Practice Address - Phone:336-724-0101
Practice Address - Fax:336-724-2241
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-22
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC365392084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry