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NPI Code Detail

MEDICARE: GREGG HARRISON TUTTLE D.O.

MEDICARE: GREGG HARRISON TUTTLE D.O.
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
1207R00000XInternal Medicine PhysicianOS013021PA
2207R00000XInternal Medicine Physician25MB05992500NJ
3208000000XPediatrics Physician25MB05992500NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1D06347700OTHERNJCDS REGISTRATION NUMBER

General Provider Information

NPI Number : 1982686408
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGG HARRISON TUTTLE D.O.
Provider Business Mailing Address
First Line : 1601 BRENNER AVE
Second Line :
City : SALISBURY
State : NC
Zip : 28144-2515
Country : US
Telephone Number : 704-638-9000
Fax Number : 704-638-3817
Provider Business Practice Location Address
First Line : 1601 BRENNER AVE
Second Line :
City : SALISBURY
State : NC
Zip : 28144-2515
Country : US
Telephone Number : 704-638-9000
Fax Number : 704-638-3817
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2005
Last Update Date : 03/07/2023

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