Gutierrez, Karl R
Gutierrez, Karl R is an individual health care provider with primary practice located at 1010 E Roosevelt Ave , Grants NM 87020-2118. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Gutierrez, Karl R can be contacted via phone (505) 287-2948.Contact Information
Primary practice address
1010 E Roosevelt Ave
Grants NM 87020-2118
Phone: (505) 287-2948
Fax: (505) 287-5372
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 79-171 | New Mexico |
Profile Details
| NPI number | 1790758571 |
|---|---|
| LBN Legal business name | Gutierrez, Karl R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 10th, 2006 |
| Last updated | Jul 9th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790758571 | NPPES |
| New Mexico | MEDICAID | 44636 | |
| New Mexico | MEDICAID | 21162 |
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