Provider Demographics
NPI:1114131935
Name:DAVID F. HUTCHEON, M.D.,LLC
Entity Type:Organization
Organization Name:DAVID F. HUTCHEON, M.D.,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:FORBES
Authorized Official - Last Name:HUTCHEON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-583-2631
Mailing Address - Street 1:10751 FALLS RD STE 401
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4568
Mailing Address - Country:US
Mailing Address - Phone:410-583-2631
Mailing Address - Fax:410-583-2845
Practice Address - Street 1:10751 FALLS RD STE 401
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4568
Practice Address - Country:US
Practice Address - Phone:410-583-2631
Practice Address - Fax:410-583-2845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0018042207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD713381200Medicaid
MD190P437GMedicare ID - Type Unspecified