Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 01048303 | IN |
NPI | 1336244912 |
---|---|
Provider Name | Gordon B Cutler JR. |
First Address | Indianapolis, IN 46206-1026 |
Second Address | Indianapolis, IN 46202-5128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G83701 | (02) |