Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 35098575 | OH |
N | 207RG0300X | Geriatric Medicine | D47451 | MD |
NPI | 1164434452 |
---|---|
Provider Name | Cynthia Kuttner |
First Address | Athens, OH 45701 |
Second Address | Athens, OH 45701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 16/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
119C | BLUE SHIELD LOCAL (01) | MD |
53543405 | BLUE SHIELD REGIONAL (01) | MD |