Fudem, Gary

Fudem, Gary is an individual health care provider with primary practice located at 325 9Th Ave Department Of Plastic & Reconstructive Surgery, Seattle WA 98104-2420. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Fudem, Gary can be contacted via phone (206) 744-5735.

Contact Information

Primary practice address
325 9Th Ave Department Of Plastic & Reconstructive Surgery Seattle WA 98104-2420
Phone: (206) 744-5735
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X MD60484351 Washington

Profile Details

NPI number 1336123454
LBN Legal business name Fudem, Gary
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2005
Last updated Dec 17th, 2014 - about 10 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 1336123454 NPPES
Washington MEDICAID 1336123454

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