Individual
DR. PETER R NUTTLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6750 N MACARTHUR BLVD STE 160, IRVING, TX 75039-2517
(469) 283-1217
(972) 869-5990
Mailing address
6750 N MACARTHUR BLVD STE 160, IRVING, TX 75039-2517
(469) 283-1217
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
40778
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007806261J
HUMANA
—
05
—
34226100
—
WI
Enumeration date
05/22/2006
Last updated
06/02/2021
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