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General NPI Number Information
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NPI Number | 1700987906
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Entity Type | Individual
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Provider Name | TODD MICHAEL TUTTLE MD
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 06/08/2015
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Provider Practice Location Address
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Address Line | 424 HARVARD ST SE MMC 195
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City | MINNEAPOLIS
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State | MN
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Zip | 55455
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Country | US
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Telephone | 612-273-5700
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Fax | 612-273-9675
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Provider Business Mailing Address
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Address Line | 420 DELAWARE STREET SE MMC 195 UNIVERSITY OF MINNESOTA PHYSICIANS
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City | MINNEAPOLIS
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State | MN
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Zip | 55455-0341
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Country | US
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Telephone | 612-273-5700
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Fax | 612-273-9675
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | 39250
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License Number State | MN
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