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General NPI Number Information
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NPI Number | 1790972784
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Entity Type | Organization
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Legal Business Name | T. TERRY CHUTINAN MD PA
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Dates
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Enumeration Date | 10/03/2007
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Last Update Date | 05/13/2010
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Provider Practice Location Address
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Address Line | 800 N HIGHWAY 434 SUITE 4
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-7041
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Country | US
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Telephone | 407-862-4242
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Fax |
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Provider Business Mailing Address
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Address Line | 800 N HIGHWAY 434 SUITE 4
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-7041
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Country | US
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Telephone | 407-862-4242
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. T. TERRY CHUTINAN
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Credential | M.D., P.A.
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Telephone | 407-862-4242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME23398
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License Number State | FL
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