Healthcare Provider Details

I. General information

NPI: 1700913159
Provider Name (Legal Business Name): PETER H HUTCHINSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 02/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 BATH RD SUITE 102
BRUNSWICK ME
04011-2637
US

IV. Provider business mailing address

430 BATH RD SUITE 102
BRUNSWICK ME
04011-2637
US

V. Phone/Fax

Practice location:
  • Phone: 207-442-0350
  • Fax: 207-442-0355
Mailing address:
  • Phone: 207-442-0350
  • Fax: 207-442-0355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD20427
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberMD20427
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: