Provider Demographics
NPI:1053439893
Name:HUTT, EDEN ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:EDEN
Middle Name:ALAN
Last Name:HUTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TOPSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01983-1831
Mailing Address - Country:US
Mailing Address - Phone:978-887-3338
Mailing Address - Fax:978-887-4265
Practice Address - Street 1:50 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOPSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01983-1831
Practice Address - Country:US
Practice Address - Phone:978-887-3338
Practice Address - Fax:978-887-4265
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2222111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY36563OtherBLUE CROSS BLUE SHIELD
MA792870OtherTUFTS PROVIDER NUMBER
MAAA7123OtherHARVARD PILGRIM PROVIDER
MA1025158OtherAETNA PROVIDER NUMBER
MA4409832OtherUNITED HEALTH CARE ID
MAY36563OtherBLUE CROSS BLUE SHIELD
MAY45473Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID