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General NPI Number Information
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NPI Number | 1447398623
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Entity Type | Individual
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Provider Name | MICHAEL E. GURULE MD
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Gender | Male
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 09/24/2019
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Provider Practice Location Address
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Address Line | 711 CHRISTOPHER DR
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City | BELEN
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State | NM
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Zip | 87002-2617
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Country | US
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Telephone | 505-248-1800
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Fax | 505-248-1917
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Provider Business Mailing Address
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Address Line | 711 CHRISTOPHER DR
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City | BELEN
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State | NM
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Zip | 87002-2617
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Country | US
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Telephone | 505-248-1800
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Fax | 505-248-1917
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 92-68
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License Number State | NM
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