Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 2222 | MA |
NPI | 1053439893 |
---|---|
Provider Name | Dr. Eden Alan Hutt |
First Address | Topsfield, MA 01983-1831 |
Second Address | Topsfield, MA 01983-1831 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1025158 | AETNA PROVIDER NUMBER (01) | MA |
4409832 | UNITED HEALTH CARE ID (01) | MA |
792870 | TUFTS PROVIDER NUMBER (01) | MA |
AA7123 | HARVARD PILGRIM PROVIDER (01) | MA |
U67039 | (02) | MA |
Y36563 | BLUE CROSS BLUE SHIELD (01) | MA |