Individual
GERARDO GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7245 RAIDER RD, BONNE TERRE, MO 63628-3767
(573) 468-4186
Mailing address
75 REMITT DRIVE, LOCKBOX 1900, CHICAGO, IL 60675-1900
(866) 916-5259
(231) 922-4030
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01046504A
IN
207P00000X
Emergency Medicine Physician
Primary
2001022240
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106267A005
BLUE SHIELD
MO
05
—
1679599518
—
MO
05
—
205762107
—
MO
05
—
205762123
—
MO
05
—
205762149
—
MO
Enumeration date
07/14/2006
Last updated
01/19/2009
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