Individual
RICHARD CLUTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
116 MONROE ST, BEAVER DAM, WI 53916-2437
(608) 359-8884
Mailing address
116 MONROE ST, BEAVER DAM, WI 53916-2437
(608) 359-8884
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
34963
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32006600
—
WI
Enumeration date
03/17/2006
Last updated
03/10/2008
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