Provider Demographics
NPI:1467016600
Name:HUTCHISON, MARCUS
Entity type:Individual
Prefix:
First Name:MARCUS
Middle Name:
Last Name:HUTCHISON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 ALBRIGHT RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-6290
Mailing Address - Country:US
Mailing Address - Phone:803-374-1573
Mailing Address - Fax:
Practice Address - Street 1:688 ALBRIGHT RD STE 101
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-6290
Practice Address - Country:US
Practice Address - Phone:803-374-1573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC34066207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty