Provider Demographics
NPI:1801299250
Name:HUGHES, ROSEMARIE (PA-C)
Entity type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
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 1:9177 ROLLING MEADOW RUN
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-3539
Mailing Address - Country:US
Mailing Address - Phone:443-742-1731
Mailing Address - Fax:
Practice Address - Street 1:115 S PINEY RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:MD
Practice Address - Zip Code:21619-2619
Practice Address - Country:US
Practice Address - Phone:410-643-3007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0005550363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC0005550OtherMD LICENSE NUMBER
1120166OtherNCCPA