Provider Demographics
NPI:1053098277
Name:HUGHES, TAMARA
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:HUGHES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431B WEST AVE # 140
Mailing Address - Street 2:
Mailing Address - City:TALLMADGE
Mailing Address - State:OH
Mailing Address - Zip Code:44278-2120
Mailing Address - Country:US
Mailing Address - Phone:330-943-3044
Mailing Address - Fax:330-944-3295
Practice Address - Street 1:1790 HAMPTON KNOLL DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-9162
Practice Address - Country:US
Practice Address - Phone:330-903-3614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRU485643172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver