1225144975 NPI number — DEAN C. GUTE MD

Table of content: VIVIAN ABOUALLOL LMHC,LCPC (NPI 1558873851)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225144975 NPI number — DEAN C. GUTE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUTE
Provider First Name:
DEAN
Provider Middle Name:
C.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225144975
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/17/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
MCFARLAND CLINKC, PC
Provider Second Line Business Mailing Address:
1215 DUFF AVE, PO BOX 3014
Provider Business Mailing Address City Name:
AMES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50010-3014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-239-4456
Provider Business Mailing Address Fax Number:
515-239-4761

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MCFARLAND CLINKC, PC
Provider Second Line Business Practice Location Address:
1215 DUFF AVE
Provider Business Practice Location Address City Name:
AMES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50010-3014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-239-4456
Provider Business Practice Location Address Fax Number:
515-239-4761
Provider Enumeration Date:
08/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  2005018592 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 37719 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1225144975 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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