MEDICARE: ANDREW TUTTLE

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	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1790610368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW TUTTLE

Provider Business Mailing Address
First Line	:	601 JOHN ST STE 100
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49007-5361
Country	:	US
Telephone Number	:	269-373-1222
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 JOHN ST STE 100
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49007-5361
Country	:	US
Telephone Number	:	269-373-1222
Fax Number	:

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

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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Directions to “ ANDREW TUTTLE ” Practice Location

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