Provider Demographics
NPI:1629021829
Name:CUTCHIN, RICHARD C (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:C
Last Name:CUTCHIN
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-7840
Mailing Address - Fax:704-384-7830
Practice Address - Street 1:517 CHESNEE HWY
Practice Address - Street 2:SUITE A
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29341-2709
Practice Address - Country:US
Practice Address - Phone:864-487-7655
Practice Address - Fax:864-487-8718
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14218207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC202660098OtherGAFFNEY HMA PHYSICIAN MANAGEMENT
SCGP4210Medicaid
SC142189Medicaid
SCC44832Medicare UPIN
SC8291Medicare PIN
SC8291Medicare ID - Type UnspecifiedDR. RICHARD CUTCHIN
SC142189Medicaid