Gortmaker, Mark F

Gortmaker, Mark F is an individual health care provider with primary practice located at One Hospital Dr , Columbia MO 65212-0001. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Gortmaker, Mark F can be contacted via phone (573) 882-2568.

Contact Information

Primary practice address
One Hospital Dr Columbia MO 65212-0001
Phone: (573) 882-2568
Fax: (573) 882-2226
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 2004016548 Missouri

Profile Details

NPI number 1649244161
LBN Legal business name Gortmaker, Mark F
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Aug 14th, 2023 - about 2 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 1649244161 NPPES
Missouri Other 127254 BLUE SHIELD/BLUE CHOICE
Missouri Other 686272 BLUE SHIELD/BLUE CHOICE
Missouri MEDICAID 5752614 BLUE SHIELD/BLUE CHOICE

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