MEDICARE: DARYL SCOTT HUTCHINSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	4301078232	MI
2	207RG0100X	Gastroenterology Physician	37854	AZ
3	208M00000X	Hospitalist Physician	4301078232	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	DH078232	OTHER	MI	BCBSM

General Provider Information

NPI Number	:	1881689792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARYL SCOTT HUTCHINSON M.D.

Provider Business Mailing Address
First Line	:	3020 E CAMELBACK RD
Second Line	:	SUITE 301
City	:	PHOENIX
State	:	AZ
Zip	:	85016-5095
Country	:	US
Telephone Number	:	602-264-9100
Fax Number	:	602-264-9101

Provider Business Practice Location Address
First Line	:	13640 N 99TH AVE
Second Line	:	STE 600
City	:	SUN CITY
State	:	AZ
Zip	:	85351-2866
Country	:	US
Telephone Number	:	623-972-2116
Fax Number	:	623-972-0521

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	02/16/2017

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