Healthcare Provider Details

I. General information

NPI: 1003385394
Provider Name (Legal Business Name): MARSHALL M HUTCHISON NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2018
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2566 HAYMAKER RD STE 306
MONROEVILLE PA
15146-3555
US

IV. Provider business mailing address

2566 HAYMAKER RD STE 306
MONROEVILLE PA
15146-3555
US

V. Phone/Fax

Practice location:
  • Phone: 412-322-7202
  • Fax: 412-322-2144
Mailing address:
  • Phone: 412-322-7202
  • Fax: 412-322-2144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP019470
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: