Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 139 | ME |
NPI | 1306068093 |
---|---|
Provider Name | David G Hutchins |
First Address | Chelsea, ME 04330-1009 |
Second Address | Chelsea, ME 04330-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AH6557992 | DEA (01) | ME |
H222001 | BLUE SHIELD (01) | ME |
T31656 | (02) | ME |