Provider Demographics
NPI:1447442702
Name:TUTTLE, SUE-MI C (MD)
Entity type:Individual
Prefix:
First Name:SUE-MI
Middle Name:C
Last Name:TUTTLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUE-MI
Other - Middle Name:
Other - Last Name:CHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7450 FRANCE AVE S STE 220
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4792
Mailing Address - Country:US
Mailing Address - Phone:952-925-1111
Mailing Address - Fax:952-922-3446
Practice Address - Street 1:7450 FRANCE AVE S STE 220
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4792
Practice Address - Country:US
Practice Address - Phone:952-925-1111
Practice Address - Fax:952-922-3446
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN51814208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery