Provider Demographics
NPI:1558368381
Name:GUTIERREZ, ANTHONY C (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:C
Last Name:GUTIERREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 E ARMOUR BLVD STE 2EAST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-1245
Mailing Address - Country:US
Mailing Address - Phone:816-394-2082
Mailing Address - Fax:855-446-7255
Practice Address - Street 1:301 E ARMOUR BLVD STE 2EAST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-1245
Practice Address - Country:US
Practice Address - Phone:816-394-2082
Practice Address - Fax:855-446-7255
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9D31207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO203796313Medicaid
MO203796313Medicaid