Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD 7826 | HI |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MD 7826 | HI |
NPI | 1407969181 |
---|---|
Provider Name | Edward William Gutteling |
First Address | Hilo, HI 96720-4405 |
Second Address | Hilo, HI 96720-4405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 06/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
073105-04 | (05) | HI |
E61096 | (02) |