Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD422188 | PA |
N | 111NI0900X | Internist | MD422188 | PA |
N | 207RC0000X | Internist - Cardiovascular Disease | MD422188 | PA |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 52342 | AZ |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD422188 | PA |
NPI | 1255329959 |
---|---|
Provider Name | Mathew D Hutchinson |
First Address | Tucson, AZ 85719-4330 |
Second Address | Tucson, AZ 85724-4306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2005 |
Last Update Date | 23/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1012758880001 | (05) | PA |
I19287 | (02) | PA |