Provider Demographics
NPI:1841703543
Name:HUGHES, CHRISTOPHER ANDREW (MILITARY SOIDC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ANDREW
Last Name:HUGHES
Suffix:
Gender:
Credentials:MILITARY SOIDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 LAYANG LAYANG CIR APT E
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-4168
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1ST MARINE RAIDER BATTALION
Practice Address - Street 2:BOX # 555341
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:92005-5341
Practice Address - Country:US
Practice Address - Phone:760-725-6576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1710I1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1297063150OtherDOD