Provider Demographics
NPI:1174593891
Name:TUTUN, BRUCE M (DC)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:M
Last Name:TUTUN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:225R KING ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2361
Mailing Address - Country:US
Mailing Address - Phone:413-584-0900
Mailing Address - Fax:413-584-2221
Practice Address - Street 1:225R KING ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2361
Practice Address - Country:US
Practice Address - Phone:413-584-0900
Practice Address - Fax:413-584-2221
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA552111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA778708OtherTUFTS PROVIDER NUMBER
MA1603442Medicaid
MA351076OtherHARVARD PILGRIM PROVIDER
MATUY35378OtherBLUE CROSS OF MA
MA000000022491OtherBOSTON HEALTHNET
MA778708OtherTUFTS PROVIDER NUMBER
MAT58141Medicare UPIN