Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 29223 | MN |
Y | 207N00000X | Dermatologist | 65947 | MN |
N | 207R00000X | Internist | 29223 | MN |
N | 111NI0900X | Internist | 29223 | MN |
NPI | 1013411081 |
---|---|
Provider Name | Scott Tuttle |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2018 |
Last Update Date | 26/08/2020 |