Provider Demographics
NPI:1831122381
Name:CUTTICA, ROBERT J (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:CUTTICA
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 1:6615 CLINGAN RD
Mailing Address - Street 2:SUITE #A
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-2196
Mailing Address - Country:US
Mailing Address - Phone:330-729-9910
Mailing Address - Fax:330-318-6257
Practice Address - Street 1:6615 CLINGAN RD
Practice Address - Street 2:SUITE #A
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-2196
Practice Address - Country:US
Practice Address - Phone:330-729-9910
Practice Address - Fax:330-318-6257
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35039065207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0316536Medicaid
OH0418645Medicare PIN
OH0316536Medicaid
OHP00437392Medicare PIN