Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 2934 | DC |
NPI | 1194739508 |
---|---|
Provider Name | Dr. Steven Alan Guttenberg |
First Address | Washington, DC 20006-1003 |
Second Address | Washington, DC 20006-1003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T31016 | (02) |