Individual
MICHAEL GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 3RD AVE SW STE D, MINOT, ND 58701-4346
(701) 223-2417
Mailing address
4909 SHELBURNE ST, BISMARCK, ND 58503-5605
(701) 223-2417
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172A00000X
Driver
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1481527
—
ND
Enumeration date
02/01/2021
Last updated
04/15/2021
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