Healthcare Provider Details

I. General information

NPI: 1871821728
Provider Name (Legal Business Name): PAMELA ESTELLE GUTMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAMELA ESTELLE SMITH

II. Dates (important events)

Enumeration Date: 12/03/2009
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FAR HORIZONS LN
ASHEVILLE NC
28803-2046
US

IV. Provider business mailing address

100 FAR HORIZONS LN
ASHEVILLE NC
28803-2046
US

V. Phone/Fax

Practice location:
  • Phone: 828-771-2219
  • Fax:
Mailing address:
  • Phone: 828-771-2219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberLP03780
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number2018-02826
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberLP03780
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: