Healthcare Provider Details

I. General information

NPI: 1699783225
Provider Name (Legal Business Name): PETER J TUTUSKA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 SW MULVANE ST
TOPEKA KS
66606-1677
US

IV. Provider business mailing address

929 SW MULVANE ST
TOPEKA KS
66606-1677
US

V. Phone/Fax

Practice location:
  • Phone: 785-270-8625
  • Fax: 785-270-8624
Mailing address:
  • Phone: 785-270-8625
  • Fax: 785-270-8624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number04-22764
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number04-22764
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: