Healthcare Provider Details
I. General information
NPI: 1871944413
Provider Name (Legal Business Name): MARIA E GUTIERREZ TORRES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/24/2016
Last Update Date: 10/25/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
51 N DUNLAP ST FL 2
MEMPHIS TN
38105-4625
US
IV. Provider business mailing address
850 POPLAR AVE BLDG 2
MEMPHIS TN
38105-4607
US
V. Phone/Fax
- Phone: 901-287-7337
- Fax: 901-287-4646
- Phone: 901-287-5594
- Fax: 901-287-6804
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0202X |
| Taxonomy | Pediatric Cardiology Physician |
| License Number | 68028 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0001X |
| Taxonomy | Clinical Cardiac Electrophysiology Physician |
| License Number | 68028 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: