Provider Demographics
NPI:1124136080
Name:HUTCHISON, PATRICIA LEE (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:LEE
Last Name:HUTCHISON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 HOPETOWN RD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-6662
Mailing Address - Country:US
Mailing Address - Phone:843-478-5650
Mailing Address - Fax:
Practice Address - Street 1:181 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29424-0001
Practice Address - Country:US
Practice Address - Phone:843-953-5520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC180562080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC180565Medicaid
G12143Medicare UPIN
SC180565Medicaid