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General NPI Number Information
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NPI Number | 1861759086
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Entity Type | Organization
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Legal Business Name | MARCIA A. GUTOWICZ MD LLC
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 50 TOWNSHIP LINE RD SUITE 222
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City | ELKINS PARK
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State | PA
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Zip | 19027-2249
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Country | US
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Telephone | 215-663-9117
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Fax | 215-947-2593
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Provider Business Mailing Address
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Address Line | 50 TOWNSHIP LINE RD SUITE 222
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City | ELKINS PARK
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State | PA
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Zip | 19027-2249
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Country | US
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Telephone | 215-663-9117
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Fax | 215-947-2593
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARCIA GUTOWICZ
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Credential | MD
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Telephone | 267-471-1711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MD020794E
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License Number State | PA
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