Basic Information
Provider Information
NPI: 1326111667
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUTCHESON
FirstName: WENDY ANN
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2101 EAST JEFFERSON STREET
Address2: PPQA MEDICARE COMPLIANCE UNIT 6 WEST
City: ROCKVILLE
State: MD
PostalCode: 208524908
CountryCode: US
TelephoneNumber: 3018166660
FaxNumber: 3018166308
Practice Location
Address1: 6104 OLD BRANCH AVENUE
Address2:  
City: TEMPLE HILLS
State: MD
PostalCode: 207482518
CountryCode: US
TelephoneNumber: 3017026100
FaxNumber: 3017026366
Other Information
ProviderEnumerationDate: 11/16/2006
LastUpdateDate: 06/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XMD34077DCN Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000X010233980VTN Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000XD59697MDY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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