Provider Demographics
NPI:1083714786
Name:GUTMANN, LUDWIG (MD)
Entity Type:Individual
Prefix:DR
First Name:LUDWIG
Middle Name:
Last Name:GUTMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:DEPT OF NEUROLOGY
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-3096
Mailing Address - Fax:319-353-7911
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:DEPT OF NEUROLOGY
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-3096
Practice Address - Fax:319-353-7911
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV088522084N0400X
IA412322084N0400X, 2084N0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD496951100Medicaid
WV0090046000Medicaid
PA0007398810001Medicaid
WVGU6006051Medicare PIN
A72485Medicare UPIN
PA0007398810001Medicaid