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General NPI Number Information
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NPI Number | 1750310710
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Entity Type | Individual
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Provider Name | RUY GUTIERREZ MD
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Gender | Male
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 300 MAIN ST.
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City | LEWISTON
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State | ME
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Zip | 04240
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Country | US
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Telephone | 207-795-8320
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Fax | 207-795-8329
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Provider Business Mailing Address
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Address Line | P.O. BOX 1849
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City | LEWISTON
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State | ME
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Zip | 04241-1849
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Country | US
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Telephone | 207-784-2554
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Fax | 207-777-5363
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 011190
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License Number State | ME
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