Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 231794 | MA |
N | 207T00000X | Neurosurgeon | 35434 | AZ |
N | 207T00000X | Neurosurgeon | 41213020 | WI |
N | 207T00000X | Neurosurgeon | MD00039363 | WA |
NPI | 1063465615 |
---|---|
Provider Name | Dr. Stephen M Gutting |
First Address | Brighton, MA 02135-2907 |
Second Address | Brighton, MA 02135-2907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 20/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
093035 | (05) | AZ |
H20883 | (02) |