Gutierrez, Rene S

Gutierrez, Rene S is an individual health care provider with primary practice located at 3400 E Market St , Logansport IN 46947-2295. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gutierrez, Rene S can be contacted via phone (574) 722-9633.

Contact Information

Primary practice address
3400 E Market St Logansport IN 46947-2295
Phone: (574) 722-9633
Fax: (574) 722-5987
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01042516 Indiana

Profile Details

NPI number 1235134834
LBN Legal business name Gutierrez, Rene S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Feb 5th, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235134834 NPPES
Indiana MEDICAID 200010560
Indiana Other 000000799590
Indiana Other P01167875

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