Healthcare Provider Details

I. General information

NPI: 1992845895
Provider Name (Legal Business Name): STEVEN E CLUTTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 COSHOCTON AVE
MOUNT VERNON OH
43050
US

IV. Provider business mailing address

40561 COUNTY ROAD 33
WARSAW OH
43844-9723
US

V. Phone/Fax

Practice location:
  • Phone: 740-393-9000
  • Fax:
Mailing address:
  • Phone: 330-473-0981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2018-00157
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.066731
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.066731
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: