Physician Compare National (NPI:1295815397)

HEALTHCARE PROVIDER: CHARLOTTE L KUTSCH MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1295815397
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5698816148
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100106000685
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KUTSCH
	Individual professional last name
Provider First Name	CHARLOTTE
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1989
	Individual professional's medical school graduation year
Primary Specialty	DERMATOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2835 FORT MISSOULA RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 302
	Group Practice or individual's line 2 address
City	MISSOULA
	Group Practice or individual's city
State	MT
	Group Practice or individual's state
Zip Code	598047424
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4067213497
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	270023
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	COMMUNITY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y