Individual
DR. FABIO ECHEVERRI GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7101 JAHNKE RD, RICHMOND, VA 23225-4017
(804) 323-8820
(804) 323-8539
Mailing address
PO BOX 36559, RICHMOND, VA 23235-8011
(804) 897-4250
(804) 897-0670
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101021805
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006603866
—
VA
01
—
220024672
RAILROAD MEDICARE
—
01
—
224094
ANTHEM-JAHNKE RD.
VA
01
—
27825
OPTIMAHEALTH
—
Enumeration date
07/27/2005
Last updated
11/30/2009
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