Provider Demographics
NPI:1811943723
Name:HUGHES, ELIZABETH L (DO)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:L
Last Name:HUGHES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5015 N ROYAL DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-9292
Mailing Address - Country:US
Mailing Address - Phone:231-935-0850
Mailing Address - Fax:231-935-0869
Practice Address - Street 1:5015 N ROYAL DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-9292
Practice Address - Country:US
Practice Address - Phone:517-913-3930
Practice Address - Fax:517-339-8501
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101015075207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0M21440034OtherMEDICARE PLUS BLUE
MI4839221Medicaid
MI4893315Medicaid
MI7887575OtherAETNA
MI1016169OtherMCLAREN HEALTH ADVANTAGE
MI200000002137OtherPHP FAMILYCARE
MI4622448Medicaid
MI0853310885OtherBCBS/BCN
MI1016169OtherMCLAREN HEALTH PLAN-COMMERCIAL
MI1016169OtherMCLAREN HEALTH PLAN-MEDICAID
MI200000002137OtherPHP
MIP00124786OtherRAILROAD MEDICARE
MI1016169OtherMCLAREN HEALTH PLAN-COMMERCIAL
MII13226Medicare UPIN