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General NPI Number Information
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NPI Number | 1669536959
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Entity Type | Individual
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Provider Name | GUILLERMO ANTONIO INFANTE GUTIERREZ MD
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Gender | Male
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 06/07/2025
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Provider Practice Location Address
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Address Line | 2301 E EVESHAM RD STE 219
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City | VOORHEES
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State | NJ
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Zip | 08043-4509
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Country | US
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Telephone | 609-506-4339
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Fax | 800-786-1838
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Provider Business Mailing Address
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Address Line | 1612 CHANTICLEER
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City | CHERRY HILL
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State | NJ
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Zip | 08003-4820
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Country | US
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Telephone | 856-424-7521
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD429827
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA08186500
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License Number State | NJ
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