Individual
CHARLES KUTINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25200 CENTER RIDGE RD, SUITE 1200, WESTLAKE, OH 44145-4141
(440) 331-3047
(440) 331-3084
Mailing address
24651 CENTER RIDGE RD, STE 350, WESTLAKE, OH 44145-5627
(440) 895-5056
(440) 333-2935
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35043393K
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119204
GROUP MEDICAID
—
05
—
0416437
—
OH
01
—
10794581
CAQH
—
01
—
120187
KAISER
—
01
—
1780634279
GROUP NPI
—
01
—
3610861
GROUP ASC MEDICARE
—
01
—
9273172
GROUP MEDICARE
—
01
—
CA4511
RR MEDICARE GROUP
—
01
—
D368301
GROUP IND DIAGNOSTICS MED
—
01
—
P00069300
RR MEDICARE INDIVIDUAL
—
Enumeration date
03/07/2006
Last updated
07/17/2017
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