| NPI Details | |
|---|---|
| NPI | 1104053180 |
| Gender | Male |
| Enumeration Date | 06/17/2009 |
| Last Updated | 03/09/2016 |
| Entity Type | Individual |
| Active | Over 8 years ago |
| Practice Location | |
|---|---|
| 979 E 3RD ST SUITE C-735 CHATTANOOGA TN, 37403-2136, US |
|
| Phone | (423) 778-9101 |
| Fax | (423) 778-9190 |
| Business Location | |
|---|---|
| 975 E 3RD ST ATTN: PROVIDER ENROLLMENT CHATTANOOGA TN, 37403-2147, US |
|
| Phone | (423) 778-3110 |
| Fax | |
| Toxanomy | |
|---|---|
| Taxonomy Code | 207P00000X |
| License State | California |
| License Number | A118952 |
| Remove 1104053180 NPI Number | |
According to our database, Dominic Fredrick Tutera M.D. NPI is 1104053180, taxonomy code is 207P00000X and license number is A118952, license state is located at California. Dominic Fredrick Tutera M.D. physically located at 979 E 3rd St, Chattanooga TN, 37403-2136. NPI Number Dominic Fredrick Tutera M.D. has the Individual type.
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1104053180 NPI number is provided on an as is basis without warranty of any kind. 1104053180 is maintained by the National Plan & Provider Enumeration System. The contents of Dominic Fredrick Tutera M.D. are for informational purposes only.
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