Individual
DR. RYAN BRADLEY TUTTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
853 N CHURCH ST, SUITE 510, SPARTANBURG, SC 29303-3098
(864) 560-7001
Mailing address
853 N CHURCH ST, SUITE 510, SPARTANBURG, SC 29303-3098
(864) 560-7001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33724
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
337246
—
SC
01
—
P01366187
RAILROAD MEDICARE
SC
Enumeration date
05/11/2011
Last updated
01/07/2021
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