Healthcare Provider Details

I. General information

NPI: 1235372616
Provider Name (Legal Business Name): SARAH LYNN HUTTO MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2009
Last Update Date: 08/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 24TH AVE S RIVERSIDE PROFESSIONAL BUILDING, SUITE 300
MINNEAPOLIS MN
55454-1455
US

IV. Provider business mailing address

606 24TH AVE S RIVERSIDE PROFESSIONAL BUILDING, SUITE 300
MINNEAPOLIS MN
55454-1455
US

V. Phone/Fax

Practice location:
  • Phone: 612-273-7111
  • Fax:
Mailing address:
  • Phone: 612-273-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number56337
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: