Organization
GUTIERREZ, MARIO A MD PA
Active
Organization
GUTIERREZ, MARIO A MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELSA GUTIERREZ (OFFICE MANAGER)
(575) 625-0977
Entity
Organization
Contact information
Practice address
313 W. COUNTRY CLUB RD, STE 14, ROSWELL, NM 88201
(575) 625-0977
(575) 625-1027
Mailing address
313 W. COUNTRY CLUB RD, STE 14, ROSWELL, NM 88201
(575) 625-0977
(575) 625-1027
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
91-213
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E1358
—
NM
Enumeration date
08/21/2006
Last updated
10/30/2007
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