Provider Demographics
NPI:1356380588
Name:MCHUGH, PETER HOWARD (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:HOWARD
Last Name:MCHUGH
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:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-765-0020
Mailing Address - Fax:336-765-0581
Practice Address - Street 1:755 HIGHLAND OAKS DR
Practice Address - Street 2:SUITE 201
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-7106
Practice Address - Country:US
Practice Address - Phone:336-765-0020
Practice Address - Fax:336-765-0581
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37969207RE0101X
NC2008-02048207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5910841Medicaid
P00447289OtherMEDICARE RAILROAD
P00447289OtherMEDICARE RAILROAD
TN3817605Medicare PIN
NC5910841Medicaid
NC2023274Medicare PIN