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Individual

ERNESTO GUTIERREZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
755 NORMAN DR, LEBANON, PA 17042-7497
(717) 273-6706
(717) 273-1435
Mailing address
755 NORMAN DR, LEBANON, PA 17042-7497
(717) 273-6706
(717) 273-1435

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD428609
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1015455900001
PA
01
1552372
GATEWAY
PA
01
50058270
CAPITAL BLUE CROSS
PA
01
GU136434
HIGHMARK BLUE SHIELD
PA
Enumeration date
07/18/2005
Last updated
02/03/2010
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