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Individual

NEMESIO E GUTIERREZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
601 BUSINESS LOOP 70 W, COLUMBIA, MO 65203-2546
(573) 884-1400
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MDR4H80
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
114225
BLUE SHIELD/BLUE CHOICE
MO
01
1500107
UNITED HEALTHCARE
MO
05
202694121
MO
01
260035875
RR MEDICARE
MO
01
33468547
ILLINOIS MEDICAID
IL
01
342200
HEALTHLINK
MO
01
K51B502
KANSAS MEDICARE
KS
Enumeration date
05/02/2006
Last updated
07/08/2007
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