Provider Demographics
NPI:1295736205
Name:GUTNIK, STEVE (MD)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:GUTNIK
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 1:1104 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-3306
Mailing Address - Country:US
Mailing Address - Phone:605-665-7841
Mailing Address - Fax:605-665-0546
Practice Address - Street 1:409 SUMMIT ST STE 2800
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-3735
Practice Address - Country:US
Practice Address - Phone:605-655-1910
Practice Address - Fax:605-655-1915
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1532207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6001242Medicaid
SD6001242Medicaid
SDD25302Medicare UPIN