Provider Demographics
NPI:1801844949
Name:HUGHES, RALPH W (PA-C)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:W
Last Name:HUGHES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 MELROSE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-1624
Mailing Address - Country:US
Mailing Address - Phone:207-396-5611
Mailing Address - Fax:207-396-5601
Practice Address - Street 1:96 CAMPUS DR
Practice Address - Street 2:SUITE 1
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7133
Practice Address - Country:US
Practice Address - Phone:207-396-5611
Practice Address - Fax:207-396-5601
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA192363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MES74668Medicare UPIN
MEAP0998Medicare ID - Type UnspecifiedMEDICARE ID NUMBER