Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 08682 | MN |
NPI | 1992703987 |
---|---|
Provider Name | Dr. James P Hughes |
First Address | Winona, MN 55987-3440 |
Second Address | Winona, MN 55987-3440 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3269859 | MN TAX ID (01) | |
38A84HU | BCBS OF MINNESOTA (01) | |
BH4833338 | DEA (01) |