Healthcare Provider Details

I. General information

NPI: 1801886015
Provider Name (Legal Business Name): DAVID A HUTCHINSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 04/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6351 E SUPERIOR ST
DULUTH MN
55804-2545
US

IV. Provider business mailing address

6351 E SUPERIOR ST
DULUTH MN
55804-2545
US

V. Phone/Fax

Practice location:
  • Phone: 218-249-4500
  • Fax: 218-249-4555
Mailing address:
  • Phone: 218-249-4500
  • Fax: 218-249-4555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number32656
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: