Provider Demographics
NPI:1578622338
Name:GUTMANN, NORMAN S (MD)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:S
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 1:6893 ISLA VISTA DR.
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33412
Mailing Address - Country:US
Mailing Address - Phone:847-987-6727
Mailing Address - Fax:833-606-0511
Practice Address - Street 1:6893 ISLA VISTA DR.
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33412
Practice Address - Country:US
Practice Address - Phone:847-987-6727
Practice Address - Fax:833-606-0511
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-065603207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC43963Medicare UPIN