Provider Demographics
NPI:1780744607
Name:NUTTER, PHILLIP E (DC)
Entity type:Individual
Prefix:
First Name:PHILLIP
Middle Name:E
Last Name:NUTTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7575 SALTSBURG ROAD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235
Mailing Address - Country:US
Mailing Address - Phone:412-795-2900
Mailing Address - Fax:412-795-7782
Practice Address - Street 1:7575 SALTSBURG ROAD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235
Practice Address - Country:US
Practice Address - Phone:412-795-2900
Practice Address - Fax:412-795-7782
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003034L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA129990OtherHIGHMARK BC
PA129990OtherHIGHMARK BC