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:
Health care specialties
| Specialty | Code | License # | 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 12 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 | 1336123454 | NPPES |
| Washington | MEDICAID | 1336123454 |
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