Individual provider · Type 1 NPI
Tyler Stephen Clutter, PA-C
Medical Physician Assistant · Mishawaka, IN
NPI number
1679285993
Active
Practice location
5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Fax (574) 523-3221
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant | 363AM0700X | None listed |
| Medical Physician Assistant Primary | 363AM0700X | 10003930A (IN) |
Medical Physician Assistant: Definition to come...
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About NPI 1679285993
Tyler Stephen Clutter, PA-C's National Provider Identifier is 1679285993, issued on Dec 19, 2022. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Mishawaka, IN. The record was last updated on Apr 8, 2025.