Provider Demographics
NPI:1861585713
Name:GUTNIK, BRUCE DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:DAVID
Last Name:GUTNIK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10050 REGENCY CIR
Mailing Address - Street 2:SUITE 501
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3704
Mailing Address - Country:US
Mailing Address - Phone:402-399-8847
Mailing Address - Fax:402-399-8848
Practice Address - Street 1:10050 REGENCY CIR
Practice Address - Street 2:SUITE 501
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3704
Practice Address - Country:US
Practice Address - Phone:402-399-8847
Practice Address - Fax:402-399-8848
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NE137872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEB90784Medicare UPIN