Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | ME94227 | FL |
NPI | 1235175183 |
---|---|
Provider Name | Dr. Warren L Hutcheson |
First Address | Fort Myers, FL 33902-2147 |
Second Address | Fort Myers, FL 33908-3618 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 06/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
273695100 | (05) | FL |
29272 | BLUE SHIELD OF FL (01) | FL |
G23498 | (02) |