Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 0401414282 | VA |
N | 213EG0000X | General Practice | 0401414282 | VA |
Y | 1223X0400X | Orthodontists | 0401414282 | VA |
NPI | 1033553771 |
---|---|
Provider Name | Dr. Justin Hughes |
First Address | Alexandria, VA 22306-3170 |
Second Address | Alexandria, VA 22306-3170 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2013 |
Last Update Date | 31/01/2019 |