Individual
ROSS G UTTER
Active
Individual
ROSS G UTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001124
CT
363AS0400X
Surgical Physician Assistant
001124
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
290001124CT02
ANTHEM
—
01
—
51124
AIM
—
01
—
711609
CTCARE
—
01
—
A437740
OXFORD
—
01
—
OR0365
AETNA HEALTHNET
—
Enumeration date
04/28/2006
Last updated
01/30/2008
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