Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 2003006409 | MO |
NPI | 1003929621 |
---|---|
Provider Name | Gregory J Kutter |
First Address | Kansas City, MO 64180-2843 |
Second Address | Springfield, MO 65807-5210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 07/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
207534108 | (05) | MO |
H84597 | (02) |