Individual
SCOTT M TUINSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5601003962
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104721043
—
MI
01
—
1407010792
BXMI
MI
01
—
OD14869
GROUP PTAN - OAM
MI
01
—
ST003962
STATE LICENSE
MI
Enumeration date
10/06/2006
Last updated
08/20/2026
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