DR. GARY FUDEM M.D. NPI 1336123454

NPI Information

NPI: 1336123454
Provider Name: DR. GARY FUDEM, M.D.
Classification: Surgery - 2086S0122X
Entity Type: Individual

Specialization: Plastic and Reconstructive Surgery

Address:
325 9TH AVE
DEPARTMENT OF PLASTIC & RECONSTRUCTIVE SURGERY
SEATTLE, WA
ZIP 98104
Phone: (206) 744-5735
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DR. Gary Fudem, M.D. is a plastic and reconstructive surgery surgery in Seattle, WA. The provider is a surgeon who specializes in plastic and reconstructive surgery. DR. Gary Fudem, M.D. NPI is 1336123454. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

325 9TH AVE
DEPARTMENT OF PLASTIC & RECONSTRUCTIVE SURGERY
SEATTLE, WA
ZIP 98104-420
Phone: (206) 744-5735

The enumeration date for this NPI number is 12/1/2005 and was last updated on 12/17/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0122X	Surgery	Plastic and Reconstructive Surgery	MD60484351	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1336123454	MEDICAID	WASHINGTON
2	8934503	MEDICARE PIN	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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