Provider Demographics
NPI:1770898561
Name:HUGHES, MICHAEL JOSEPH (MOT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:HUGHES
Suffix:
Gender:M
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:25115 GLACIER HWY
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-8106
Mailing Address - Country:US
Mailing Address - Phone:505-377-4733
Mailing Address - Fax:855-254-6287
Practice Address - Street 1:2301 YALE BLVD SE STE A3
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4350
Practice Address - Country:US
Practice Address - Phone:505-385-8028
Practice Address - Fax:505-323-2459
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2285225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist