Provider Demographics
NPI:1417922311
Name:HITCHINGS, CHERYL A (PA)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:A
Last Name:HITCHINGS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 COMMUNICATIONS WAY
Mailing Address - Street 2:MACC-REVENUE CYCLE
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-1866
Mailing Address - Country:US
Mailing Address - Phone:508-957-8664
Mailing Address - Fax:508-957-8677
Practice Address - Street 1:1 TROWBRIDGE ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:BOURNE
Practice Address - State:MA
Practice Address - Zip Code:02532
Practice Address - Country:US
Practice Address - Phone:508-743-0322
Practice Address - Fax:508-759-2478
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA678363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S39735Medicare UPIN
AP0360Medicare ID - Type Unspecified