Provider Demographics
NPI:1073599023
Name:TUTAK, UNAL (MD)
Entity Type:Individual
Prefix:DR
First Name:UNAL
Middle Name:
Last Name:TUTAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 BROOKWOOD BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6862
Mailing Address - Country:US
Mailing Address - Phone:205-802-6565
Mailing Address - Fax:205-802-6506
Practice Address - Street 1:513 BROOKWOOD BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6862
Practice Address - Country:US
Practice Address - Phone:205-802-6565
Practice Address - Fax:205-802-6506
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7305207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000038677Medicaid
AL000038677Medicaid
ALC71592Medicare UPIN
AL000038677Medicare PIN