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General NPI Number Information
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NPI Number | 1619029824
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Entity Type | Organization
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Legal Business Name | KUTTERUF AND ROBINSON MD PA
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 1607 LINCOLN WAY SUITE 200
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2462
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Country | US
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Telephone | 203-667-5483
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Fax | 208-667-7062
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Provider Business Mailing Address
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Address Line | 1607 LINCOLN WAY SUITE 200
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City | COEUR D ALENE
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State | ID
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Zip | 83814-2462
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Country | US
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Telephone | 203-667-5483
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Fax | 208-667-7062
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Authorized Official
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Title or Position | BUSINESS OFFICE ADMINISTRATOR
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Name | JEAN M NELSON
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Credential |
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Telephone | 208-667-5483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | M3978
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | M3977
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License Number State | ID
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