Provider Demographics
NPI:1023410008
Name:HATCH, DAVID ROBERT
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ROBERT
Last Name:HATCH
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 1:22325 GREENVIEW PKWY UNIT 1A
Mailing Address - Street 2:
Mailing Address - City:GREAT MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20634-4405
Mailing Address - Country:US
Mailing Address - Phone:301-862-3338
Mailing Address - Fax:301-862-3335
Practice Address - Street 1:22325 GREENVIEW PKWY UNIT 1A
Practice Address - Street 2:
Practice Address - City:GREAT MILLS
Practice Address - State:MD
Practice Address - Zip Code:20634-4405
Practice Address - Country:US
Practice Address - Phone:301-862-3338
Practice Address - Fax:301-862-3335
Is Sole Proprietor?:No
Enumeration Date:2014-09-21
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MD01665213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program