Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301039990 | MI |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 4301039990 | MI |
NPI | 1003921438 |
---|---|
Provider Name | Raymond J Hutchinson |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-4257 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 07/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1297238 | (05) | MI |
B48786 | (02) | MI |