Provider Demographics
NPI:1881640266
Name:LUTIN, CHARLES DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:DAVID
Last Name:LUTIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:601 S ENOTA DR NE
Mailing Address - Street 2:SUITE Q
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2400
Mailing Address - Country:US
Mailing Address - Phone:770-219-8206
Mailing Address - Fax:770-219-7778
Practice Address - Street 1:597 S ENOTA DR NE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2545
Practice Address - Country:US
Practice Address - Phone:770-219-8206
Practice Address - Fax:770-219-7778
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2012-06-25
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Provider Licenses
StateLicense IDTaxonomies
GA067061207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine