Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207NS0135X | Procedural Dermatology | 34066 | SC |
NPI | 1467016600 |
---|---|
Provider Name | Marcus Hutchison |
First Address | Rock Hill, SC 29730-6290 |
Second Address | Rock Hill, SC 29730-6290 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2019 |
Last Update Date | 23/04/2019 |