Individual
JOHN GUTTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 RIO BRAVO BLVD SE, ALBUQUERQUE, NM 87105
(505) 873-6400
(505) 873-6403
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
82-58
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
25353
—
NM
Enumeration date
07/11/2006
Last updated
03/23/2018
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