Amundson, Gary M

Amundson, Gary M is an individual health care provider with primary practice located at 750 E Adams St , Syracuse NY 13210-2342. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Radiology, which is considered as his primary health care specialty. Amundson, Gary M can be contacted via phone (315) 464-7433.

Contact Information

Primary practice address
750 E Adams St Syracuse NY 13210-2342
Fax:
Website:

Profile Details

NPI number 1720031446
LBN Legal business name Amundson, Gary M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Jan 24th, 2013 - about 11 years ago

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 1720031446 NPPES
Kentucky Other 64037203 MEDICAID
Kentucky Other 000000565302 MEDICAID
Kentucky Other 00533040 MEDICAID
Kentucky Other 3525222000 MEDICAID
Kentucky Other 50019410 MEDICAID
Kentucky Other 096386 MEDICAID
Kentucky MEDICAID 200331670 MEDICAID
Kentucky Other 0000230324 MEDICAID

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