Individual
HEATHER RIVERA GUTEKUNST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10880 DURANT RD, SUITE 200, RALEIGH, NC 27614-6628
(919) 846-0800
(919) 846-0880
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
2008-00939
NC
207K00000X
Allergy & Immunology Physician
200800939
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720247646
—
NC
01
—
NC0584B
MEDICARE PTAN
NC
Enumeration date
06/05/2008
Last updated
10/30/2023
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