MEDICARE: MATTHEW J GUTIERREZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	35-085292	OH
2	207RC0000X	Cardiovascular Disease Physician	234464-1	NY
3	207RC0000X	Cardiovascular Disease Physician	MD423985	PA
4	207RC0000X	Cardiovascular Disease Physician	17508	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508860552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW J GUTIERREZ MD

Provider Business Mailing Address
First Line	:	246 PLEASANT STREET MEMORIAL BUILDING, WEST, GROUND FLO
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-2548
Country	:	US
Telephone Number	:	603-224-6070
Fax Number	:	603-224-6094

Provider Business Practice Location Address
First Line	:	246 PLEASANT STREET MEMORIAL BUILDING, WEST, GROUND FLO
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-2548
Country	:	US
Telephone Number	:	603-224-6070
Fax Number	:	603-224-6094

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	07/22/2020

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