Healthcare Provider Details
I. General information
NPI: 1043445976
Provider Name (Legal Business Name): ELEANOR HUTCHENS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/21/2009
Last Update Date: 05/10/2023
Certification Date: 05/10/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15 SPORTS MEDICINE DR. SUITE 100
FISHERSVILLE VA
22939
US
IV. Provider business mailing address
PO BOX 388
FISHERSVILLE VA
22939-0388
US
V. Phone/Fax
- Phone: 540-221-7180
- Fax: 540-221-7181
- Phone: 540-932-5162
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | D0073651 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RE0101X |
| Taxonomy | Endocrinology, Diabetes & Metabolism Physician |
| License Number | 0116025469 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: