Gonda, Jeremy Mark
Gonda, Jeremy Mark is an individual health care provider with primary practice located at 1155 Mill St Ms W14 , Reno NV 89502-1576. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Gonda, Jeremy Mark can be contacted via phone (775) 982-7878.Contact Information
Primary practice address
1155 Mill St Ms W14
Reno NV 89502-1576
Phone: (775) 982-7878
Fax: (775) 982-4196
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 14342 | Nevada |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | 14342 | Nevada |
Profile Details
| NPI number | 1073635348 |
|---|---|
| LBN Legal business name | Gonda, Jeremy Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 6th, 2007 |
| Last updated | Jun 23rd, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073635348 | NPPES |
| Other | 12553643 | CAQH | |
| MEDICAID | 1073635348 | CAQH |
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