Individual
ELISA GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
MSC 09 5040, 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 272-6607
Mailing address
455 ST. MICHAEL'S DRIVE, SANTA FE, NM 87505
(505) 913-6130
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2017-0266
NM
390200000X
Student in an Organized Health Care Education/Training Program
RS2014-0291
NM
Other
Enumeration date
05/16/2014
Last updated
08/10/2017
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