Provider Demographics
NPI:1336759083
Name:HUGHES, MARTHA MCCARY
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:MCCARY
Last Name:HUGHES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5613 CLAY BANK RD
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-3503
Mailing Address - Country:US
Mailing Address - Phone:804-693-2568
Mailing Address - Fax:804-693-0606
Practice Address - Street 1:5613 CLAY BANK RD
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061-3503
Practice Address - Country:US
Practice Address - Phone:804-693-2568
Practice Address - Fax:804-693-0606
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)