Provider Demographics
NPI:1114926813
Name:HUTCHINS, MATTHEW G (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:G
Last Name:HUTCHINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7502 STATE RD STE 2210A
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-2596
Mailing Address - Country:US
Mailing Address - Phone:513-624-2070
Mailing Address - Fax:513-624-2077
Practice Address - Street 1:7502 STATE RD STE 2210A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-2596
Practice Address - Country:US
Practice Address - Phone:513-624-2070
Practice Address - Fax:513-624-2077
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.069252207RC0000X
OH35069252207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2222580Medicaid
IN200323140Medicaid
KY64027485Medicaid
OH4085728Medicare PIN
IN200323140Medicaid