Deandre Lavelle Hughes

Individual provider Active NPI Driver · Bay City, MI

NPI 1669028569 · NPPES record last updated Aug 15, 2019

Key facts

NPI
1669028569
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
License
H220139488070 (MI)
Practice address
706 Patterson Ave
Bay City, MI 48706-4194
Phone
(989) 400-2583
Fax
(989) 956-5914
NPI assigned
Aug 15, 2019
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
H220139488070MIMDDriver

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver
Group: 193400000X SINGLE SPECIALTY GROUP
172A00000X H220139488070 MI Yes

Addresses

Primary practice location

706 Patterson Ave
Bay City, MI 48706-4194

Mailing address

706 Patterson Ave
Bay City, MI 48706-4194
Phone (989) 400-2583

Other providers in Bay City, MI

All providers in Bay City, MI · Driver in Michigan

Sources for this page

Verify at the official NPI Registry.