Basic Information
Provider Information
NPI: 1326098963
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUTTER
FirstName: GEORGE
MiddleName: E.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 700 6TH ST S
Address2: 3RD FLOOR
City: ST PETERSBURG
State: FL
PostalCode: 337014815
CountryCode: US
TelephoneNumber: 7278936116
FaxNumber: 7275537340
Practice Location
Address1: 700 6TH ST S
Address2: 3RD FLOOR
City: ST PETERSBURG
State: FL
PostalCode: 337014815
CountryCode: US
TelephoneNumber: 7278936116
FaxNumber: 7275537340
Other Information
ProviderEnumerationDate: 05/12/2006
LastUpdateDate: 09/14/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XME73737FLY Allopathic & Osteopathic PhysiciansFamily Medicine 

ID Information
IDTypeStateIssuerDescription
25283630005FL MEDICAID
08013350601FLRAILROAD MEDICARE NUMBEROTHER


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