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Individual

ALLEN L GUTOVITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4330 WORNALL RD, SUITE 2000, KANSAS CITY, MO 64111-5939
(816) 931-1883
(816) 756-3645
Mailing address
901 E 104TH ST, MAILSTOP 400S, KANSAS CITY, MO 64131
(816) 502-7117
(816) 932-9670

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
R6033
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100081660B
KS
05
100081660D
KS
05
100081660H
KS
05
10081660I
KS
05
207318106
MO
01
KA1021018
MEDICARE - CUSHING
KS
01
P00842608
RAILROAD MEDICARE
KS
01
P00842669
RAILROAD MEDICARE
MO
Enumeration date
05/03/2006
Last updated
11/09/2017
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