Provider Demographics
NPI:1396706156
Name:HUTCHINS, CHARLES HUBERT (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:HUBERT
Last Name:HUTCHINS
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 1:750 COX RD
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-3481
Mailing Address - Country:US
Mailing Address - Phone:704-867-7212
Mailing Address - Fax:704-867-7655
Practice Address - Street 1:750 COX RD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-3481
Practice Address - Country:US
Practice Address - Phone:704-867-7212
Practice Address - Fax:704-867-7655
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17069204D00000X, 207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Not Answered207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8945146Medicaid
C84659Medicare UPIN
207480Medicare ID - Type Unspecified