Healthcare Provider Details

I. General information

NPI: 1013018993
Provider Name (Legal Business Name): MARY E HUTCHINS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 04/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1665 VALLEY CENTER PKWY SUITE 120
BETHLEHEM PA
18017-2346
US

IV. Provider business mailing address

1665 VALLEY CENTER PKWY SUITE 120
BETHLEHEM PA
18017-2346
US

V. Phone/Fax

Practice location:
  • Phone: 610-868-3150
  • Fax: 610-868-3156
Mailing address:
  • Phone: 610-868-3150
  • Fax: 610-868-3156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD062784L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: