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Individual

DR. STACEY LYNN GUTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
512 SKYLINE BLVD STE 1, CLOQUET, MN 55720-1199
(218) 879-4641
(218) 878-7081
Mailing address
24 MILES CENTER WAY, DAMARISCOTTA, ME 04543-4067
(207) 563-4252
(759) 323-6840

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
77119
MN
208600000X
Surgery Physician
MD21753
ME
208600000X
Surgery Physician
R2933
KY

Other

Enumeration date
05/03/2012
Last updated
09/25/2024
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