Provider Demographics
NPI:1780680223
Name:MCHUGH, TIMOTHY A (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:A
Last Name:MCHUGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5333 MCAULEY DR
Mailing Address - Street 2:RM 3001
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1097
Mailing Address - Country:US
Mailing Address - Phone:734-712-8100
Mailing Address - Fax:734-712-8112
Practice Address - Street 1:5333 MCAULEY DR
Practice Address - Street 2:RM 3001
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1097
Practice Address - Country:US
Practice Address - Phone:734-712-8100
Practice Address - Fax:734-712-8112
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MITM039009208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI340H110900OtherBLUE CARE NETWORK
MI4146999Medicaid
MI383461163006OtherCIGNA
MI013886OtherMIDWEST HEALTH PLAN
MI102708OtherCARE CHOICES
MI102708OtherPREFERRED CHOICES
MI340020259OtherRR MEDICARE UNITED HEALTH
MI340H110900OtherBCBSM
MI4146999Medicaid
MI340H110900OtherBLUE CARE NETWORK