Individual
DR. STEFAN H. GUTOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
610 BROADWAY BLVD NE, ALBUQUERQUE, NM 87102-2372
(505) 242-3991
(505) 243-8405
Mailing address
610 BROADWAY BLVD NE, ALBUQUERQUE, NM 87102-2372
(505) 242-3991
(505) 243-8405
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD2008-0667
NM
208800000X
Urology Physician
MD2008-0667
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01132504
—
NM
Enumeration date
05/30/2006
Last updated
05/19/2016
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