Healthcare Provider Details

I. General information

NPI: 1114926813
Provider Name (Legal Business Name): MATTHEW G HUTCHINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 01/17/2020
Certification Date: 01/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7502 STATE RD STE 2210A
CINCINNATI OH
45255-2596
US

IV. Provider business mailing address

7502 STATE RD STE 2210A
CINCINNATI OH
45255-2596
US

V. Phone/Fax

Practice location:
  • Phone: 513-624-2070
  • Fax: 513-624-2077
Mailing address:
  • Phone: 513-624-2070
  • Fax: 513-624-2077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35.069252
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number35069252
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: