Individual
MR. HUGH CHARLES MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2210 WILBORN AVE, SOUTH BOSTON, VA 24592-1630
(434) 575-5864
Mailing address
7203 QUINCY AVE, FALLS CHURCH, VA 22042-1621
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003825
VA
Other
Enumeration date
02/20/2012
Last updated
02/20/2012
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