Provider Demographics
NPI:1780665604
Name:HUTTER, MATTHEW M (MD MPH)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:M
Last Name:HUTTER
Suffix:
Gender:M
Credentials:MD MPH
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-2819
Mailing Address - Fax:617-724-3418
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:WAC 335
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-2819
Practice Address - Fax:617-724-3418
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2012-07-19
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Provider Licenses
StateLicense IDTaxonomies
MA214150208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0171280Medicaid
MA411655OtherTUFTS HEALTH PLAN
MAJ24905OtherBCBS MA
MA411655OtherTUFTS HEALTH PLAN
H62929Medicare UPIN