Provider Demographics
NPI:1851437842
Name:TUTEN, SEAN A (DA)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:A
Last Name:TUTEN
Suffix:
Gender:M
Credentials:DA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 TABER AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4129
Mailing Address - Country:US
Mailing Address - Phone:401-569-0222
Mailing Address - Fax:
Practice Address - Street 1:144 WATERMAN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2126
Practice Address - Country:US
Practice Address - Phone:401-569-0222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDA00285171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist