Provider Demographics
NPI:1922055334
Name:HUTCHINSON, MATTHEW ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ALAN
Last Name:HUTCHINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:16326 GULF BLVD
Mailing Address - Street 2:UNIT 503
Mailing Address - City:NORTH REDINGTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33708-1588
Mailing Address - Country:US
Mailing Address - Phone:727-398-9363
Mailing Address - Fax:727-398-9575
Practice Address - Street 1:10000 BAY PINES BLVD
Practice Address - Street 2:
Practice Address - City:BAY PINES
Practice Address - State:FL
Practice Address - Zip Code:33744
Practice Address - Country:US
Practice Address - Phone:727-398-9363
Practice Address - Fax:727-398-9575
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL00115842085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51096549OtherBLUE CROSS BLUE SHIELD
AL13866OtherTHE OATH
FL1922055334OtherDEPT OF VETERANS AFFAIRS
AL51096548OtherBLUE CROSS BLUE SHIELD
AL51084766OtherBLUE CROSS BLUE SHIELD
AL51096551OtherBLUE CROSS BLUE SHIELD
FL1922055334OtherDEPT OF VETERANS AFFAIRS