Individual
DR. GUSTAVO GUTNISKY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1051 GAUSE BLVD, SUITE 410, SLIDELL, LA 70458-2951
(985) 641-4152
(985) 641-4153
Mailing address
1051 GAUSE BLVD, SUITE 410, SLIDELL, LA 70458-2995
(985) 641-4152
(985) 641-4153
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
05999R
LA
Other
Enumeration date
02/01/2006
Last updated
07/08/2007
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