Provider Demographics
NPI:1821369240
Name:CUTLER, NATHAN E (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:E
Last Name:CUTLER
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 1:29201 TELEGRAPH RD STE 606
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1300
Mailing Address - Country:US
Mailing Address - Phone:248-356-8610
Mailing Address - Fax:
Practice Address - Street 1:29201 TELEGRAPH RD STE 606
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1300
Practice Address - Country:US
Practice Address - Phone:248-356-8610
Practice Address - Fax:248-356-2850
Is Sole Proprietor?:No
Enumeration Date:2012-01-17
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMT207072207W00000X
MI4301117083207WX0107X, 207W00000X, 207WX0107X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program