Healthcare Provider Details

I. General information

NPI: 1780971812
Provider Name (Legal Business Name): ERIC HUTTENBACH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2011
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 HODGES AVE
TAUNTON MA
02780-3034
US

IV. Provider business mailing address

60 HODGES AVE
TAUNTON MA
02780-3034
US

V. Phone/Fax

Practice location:
  • Phone: 508-977-3223
  • Fax: 508-977-3636
Mailing address:
  • Phone: 508-977-3223
  • Fax: 508-977-3636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number249028
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: