Gutierrez Amezcua, Jose Manuel

Gutierrez Amezcua, Jose Manuel is an sole proprietor health care provider with primary practice located at 111 Colchester Ave , Burlington VT 05401-1473. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Gutierrez Amezcua, Jose Manuel can be contacted via phone (802) 847-0000.

Contact Information

Primary practice address
111 Colchester Ave Burlington VT 05401-1473
Phone: (802) 847-0000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X New York
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 042.0018655 Vermont

Profile Details

NPI number 1154983971
LBN Legal business name Gutierrez Amezcua, Jose Manuel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 2nd, 2019
Last updated Jul 9th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154983971 NPPES
New York MEDICAID 13-3971298

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