Provider Demographics
NPI:1710177852
Name:HUEBL, HUBERT C (MD)
Entity Type:Individual
Prefix:
First Name:HUBERT
Middle Name:C
Last Name:HUEBL
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 1:136 S HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-1444
Mailing Address - Country:US
Mailing Address - Phone:313-359-0253
Mailing Address - Fax:
Practice Address - Street 1:136 S HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-1444
Practice Address - Country:US
Practice Address - Phone:313-359-0253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA31145208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery