Healthcare Provider Details

I. General information

NPI: 1215083068
Provider Name (Legal Business Name): REBECCA NEWLIN HUTCHINSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA CANDACE NEWLIN

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 09/28/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 BRAMHALL ST
PORTLAND ME
04102-3134
US

IV. Provider business mailing address

22 BRAMHALL ST
PORTLAND ME
04102-3134
US

V. Phone/Fax

Practice location:
  • Phone: 617-780-2964
  • Fax:
Mailing address:
  • Phone: 215-662-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberMD20633
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: