Provider Demographics
NPI:1457689358
Name:GINO TUTERA MD, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:GINO TUTERA MD, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DEVELOPMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLANN
Authorized Official - Middle Name:
Authorized Official - Last Name:TUTERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-874-1515
Mailing Address - Street 1:8412 E SHEA BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6664
Mailing Address - Country:US
Mailing Address - Phone:480-874-1515
Mailing Address - Fax:480-991-8395
Practice Address - Street 1:8412 E SHEA BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6664
Practice Address - Country:US
Practice Address - Phone:480-874-1515
Practice Address - Fax:480-991-8395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28759207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty