Provider Demographics
NPI:1003820135
Name:TUTTLE, GREGORY HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:HOWARD
Last Name:TUTTLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:201 INTERN WAY
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6054
Mailing Address - Country:US
Mailing Address - Phone:919-493-7046
Mailing Address - Fax:919-966-0108
Practice Address - Street 1:JAMES A TAYLOR CAMPUS HEALTH SERVIVE
Practice Address - Street 2:THE UNIVERSITY OF NORTH CAROLINA, CB#7470
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7470
Practice Address - Country:US
Practice Address - Phone:919-966-6551
Practice Address - Fax:919-966-0108
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCNC 23457207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCBO9575Medicare UPIN