Provider Demographics
NPI:1740279140
Name:GUTSTEIN, DAVID M (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:GUTSTEIN
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 1:15621 NEW HAMPSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-4123
Mailing Address - Country:US
Mailing Address - Phone:239-466-8838
Mailing Address - Fax:239-466-7669
Practice Address - Street 1:15621 NEW HAMPSHIRE CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4123
Practice Address - Country:US
Practice Address - Phone:239-466-8838
Practice Address - Fax:239-466-7669
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME65573207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00281527OtherRAILROAD MEDICARE PROVIDER NUMBER
FLP00281527OtherRAILROAD MEDICARE PROVIDER NUMBER
FL25220YMedicare PIN
FLE15781Medicare UPIN