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1508884255 NPI number — ERIC MOORE CUTTI MD

NPI Number: 1508884255
Health Care Provider/Practitioner: ERIC MOORE CUTTI MD

Information about “1508884255” NPI (ERIC MOORE CUTTI MD) exists in 1508884255 in HTML format HTML  |  1508884255 in plain Text format TXT  |  1508884255 in PDF (Portable Document Format) PDF  |  1508884255 in an XML format XML  formats.

NPI Number : 1508884255 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508884255",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CUTTI",
    "FirstName": "ERIC",
    "MiddleName": "MOORE",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1542 WHITE VIOLET WAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LOUISVILLE",
    "MailingAddressStateName": "CO",
    "MailingAddressPostalCode": "80027-2436",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "717-887-6176",
    "MailingAddressFaxNumber": "303-492-8222",
    "FirstLinePracticeLocationAddress": "1900 WARDENBURG DRIVE UCB 119",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BOULDER",
    "PracticeLocationAddressStateName": "CO",
    "PracticeLocationAddressPostalCode": "80309-9346",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "303-492-5101",
    "PracticeLocationAddressFaxNumber": "303-492-8222",
    "EnumerationDate": "07/18/2006",
    "LastUpdateDate": "12/14/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "MD068455L",
          "LicenseNumberStateCode": "PA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "MA66161",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "D0055025",
          "LicenseNumberStateCode": "MD",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": "DR.0067206",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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