Provider Demographics
NPI:1962814194
Name:HUGHES, DWIGHT AVERY JR (NRP, CHW)
Entity type:Individual
Prefix:MR
First Name:DWIGHT
Middle Name:AVERY
Last Name:HUGHES
Suffix:JR
Gender:M
Credentials:NRP, CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 E PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-2241
Mailing Address - Country:US
Mailing Address - Phone:248-247-0584
Mailing Address - Fax:
Practice Address - Street 1:2111 WOODWARD AVE STE 1200
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-3415
Practice Address - Country:US
Practice Address - Phone:313-546-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172V00000X
390200000X
MI1911986146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No172V00000XOther Service ProvidersCommunity Health Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program