MARK LIVINGSTON JUTRAS (NPI# 1093771792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093771792 |
Entity Type | Individual |
Full Name | MARK LIVINGSTON JUTRAS |
Credential | MD |
Practice Address |
1918 Randolph Rd Ste 210 Charlotte NC 28207-1109 |
Practice Telephone | 7049479000 |
Practice Fax Number | 7049921900 |
Mailing Telephone | 7049479000 |
Mailing Fax Number | 7049921900 |
Enumeration Date | 2006-04-22 |
Last Update Date | 2018-03-17 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207VE0102X |
Obstetrics & Gynecology Specialization: Reproductive Endocrinology |
2006-01581 | NC | Allopathic & Osteopathic Physicians |
N | 207VE0102X |
Obstetrics & Gynecology Specialization: Reproductive Endocrinology |
54438 | FL | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
615 E Princeton St, Ste. 225, Orlando, FL 328031456 | 4078967575 | 4078942692 |
Street Address |
1918 RANDOLPH RD STE 210 |
City | CHARLOTTE |
State | NC |
Zip Code | 28207-1109 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427565696 | Advanced Reproductive Concepts, Pllc | Obstetrics & Gynecology | 1918 Randolph Rd Ste 210, Charlotte, NC 28207-1109 | 2018-01-09 |
1700809035 | Matrika D. Johnson | Obstetrics & Gynecology | 1918 Randolph Rd Ste 210, Charlotte, NC 28207-1109 | 2006-07-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013560739 | Louis Roncaglione | Dentist | 8815 Christenbury Pkway, Concord, NC 28207 | 2019-07-22 |
1619430014 | Khrystyna Levytska | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Ob/gyn, 1350 S. Kings Dr., Charlotte, NC 28207 | 2019-04-11 |
1649743584 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 1005 South Kings Drive, Charlotte, NC 28207 | 2019-01-03 |
1023584489 | Herron and Smith Associates, Pllc | Dentist | 135 Perrin Place, Suite 100, Charlotte, NC 28207 | 2018-10-23 |
1588161640 | Lauren Mogk | Student in an Organized Health Care Education/Training Program | Myers Park Clinical Internal Medicine, 1350 S. Kings Dr., 3rd Floor, Charlotte, NC 28207 | 2018-04-06 |
1518462241 | Sarah Hollyn Carlock | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Internal Medicine, 1350 S Kings Dr, 3rd Floor, Charlotte, NC 28207 | 2018-03-26 |
1083118178 | Claire Milam | Student in an Organized Health Care Education/Training Program | Cmc/department of Emergency Medicine, 100 Blythe Blvd, Charlotte, NC 28207 | 2018-03-22 |
1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
1063945467 | Kaitlyn O'keefe | Internal Medicine | 1350 S. Kings Dr., 3rd Floor, Myers Park Clinic Internal Medicine, Charlotte, NC 28207 | 2017-04-04 |
1811432024 | Advanced Prosthetics of Easley, Inc | Durable Medical Equipment & Medical Supplies | 2310 Randolph Rd Ste A, Charlotte, NC 28207 | 2016-12-23 |
Find all providers in zip 28207 |
Taxonomy Code | 207VE0102X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Obstetrics & Gynecology |
Specialization | Reproductive Endocrinology |
An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457986937 | Carolinas Fertility Institute | Obstetrics & Gynecology | 2614 E 7th St Ste C, Charlotte, NC 28204-4397 | 2020-03-05 |
1639254345 | Seth Katz | Obstetrics & Gynecology | 1524 East Morehead Street, Charlotte, NC 28207 | 2006-10-25 |
1528669710 | Care Fertility Pllc | Obstetrics & Gynecology | 1524 E Morehead St, Charlotte, NC 28207-1606 | 2020-11-04 |
1427565696 | Advanced Reproductive Concepts, Pllc | Obstetrics & Gynecology | 1918 Randolph Rd Ste 210, Charlotte, NC 28207-1109 | 2018-01-09 |
1548693872 | Carolinas Medical Center | Obstetrics & Gynecology | 1025 Morehead Medical Dr, Suite 525, Charlotte, NC 28204-2963 | 2013-08-09 |
1194991463 | Tolga Mesen | Obstetrics & Gynecology | 200 Hawthorne Ln, Charlotte, NC 28204-2515 | 2008-05-06 |
1588830822 | Lauren Noelle Collins Johnson | Obstetrics & Gynecology | 1524 E Morehead St, Charlotte, NC 28207-1606 | 2008-05-06 |
1700809035 | Matrika D. Johnson | Obstetrics & Gynecology | 1918 Randolph Rd Ste 210, Charlotte, NC 28207-1109 | 2006-07-26 |
1619992740 | Michelle Matthews | Obstetrics & Gynecology | 1025 Morehead Medical Dr, Ste 500 5th Floor, Charlotte, NC 28204-2963 | 2006-07-12 |
1255337069 | Gordon Bruce Kuttner | Obstetrics & Gynecology | 3325 Springbank Ln, Ste 300, Charlotte, NC 28226-3364 | 2005-06-27 |
Find all providers in CHARLOTTE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.