MEDICARE: TIMOTHY M. TUTHILL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	35030473T	OH

General Provider Information

NPI Number	:	1598714958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY M. TUTHILL M.D.

Provider Business Mailing Address
First Line	:	6559 WILSON MILLS RD
Second Line	:	SUITE 106
City	:	CLEVELAND
State	:	OH
Zip	:	44143-6402
Country	:	US
Telephone Number	:	440-449-1540
Fax Number	:	440-460-2833

Provider Business Practice Location Address
First Line	:	6559 WILSON MILLS RD
Second Line	:	SUITE 106
City	:	MAYFIELD VILLAGE
State	:	OH
Zip	:	44143-6402
Country	:	US
Telephone Number	:	440-449-1540
Fax Number	:	440-460-2833

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	12/13/2007

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