Individual
DR. JUSTIN E. HUGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
714 GRAVOIS RD, SUITE 210, FENTON, MO 63026-7727
(314) 543-5230
(314) 543-5280
Mailing address
714 GRAVOIS RD, SUITE 210, FENTON, MO 63026-7727
(314) 543-5230
(314) 543-5280
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2004002167
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208987800
—
MO
Enumeration date
07/21/2005
Last updated
04/07/2010
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