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General NPI Number Information
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NPI Number | 1356318653
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Entity Type | Individual
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Provider Name | MARVIN GUTER MD
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Gender | Male
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Dates
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Enumeration Date | 03/06/2006
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Last Update Date | 12/14/2010
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Provider Practice Location Address
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Address Line | 15609 BUTTERFISH PL
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City | LAKEWOOD RANCH
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State | FL
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Zip | 34202
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Country | US
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Telephone | 941-755-6350
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 110099
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City | LAKEWOOD RCH
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State | FL
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Zip | 34211-0002
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Country | US
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Telephone | 941-755-6350
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 117106
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License Number State | NY
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