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Individual
DR. MARK R GUTEKUNST
Active
Individual
DR. MARK R GUTEKUNST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104001152
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042725
ANTHEM BLUE CROSS
VA
01
—
10384080
CAQH
—
01
—
1790973
CIGNA
—
01
—
44-00363
UNITED HEALTH CARE
—
01
—
4657152
AETNA
—
Enumeration date
06/23/2006
Last updated
12/15/2011
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