Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 2019-00266 | NC |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | MT215142 | PA |
NPI | 1689917205 |
---|---|
Provider Name | Dr. Michael Stevenson Hughes |
First Address | Winston Salem, NC 27157-1070 |
Second Address | Winston Salem, NC 27103-2508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2013 |
Last Update Date | 18/11/2019 |