Provider Demographics
NPI:1235491986
Name:GUTTELING ENTERPRISES, LLC
Entity Type:Organization
Organization Name:GUTTELING ENTERPRISES, LLC
Other - Org Name:EDWARD GUTTELING, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:GUTTELING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-961-2609
Mailing Address - Street 1:670 KEKUANAOA ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-4405
Mailing Address - Country:US
Mailing Address - Phone:808-961-2609
Mailing Address - Fax:808-969-9262
Practice Address - Street 1:670 KEKUANAOA ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-4405
Practice Address - Country:US
Practice Address - Phone:808-961-2609
Practice Address - Fax:808-969-9262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-08
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 7826207XS0114X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Single Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty