Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 169393 | NY |
Y | 207X00000X | Orthopaedic Surgeon | 169393 | NY |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 169393 | NY |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 169393 | NY |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 169393 | NY |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 169393 | NY |
NPI | 1245267913 |
---|---|
Provider Name | Andrew George Gunther |
First Address | Albany, NY 12212-4890 |
Second Address | Troy, NY 12182-3237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 21/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10000823 | CDPHP (01) | NY |
D02329 | (02) | NY |
OS 169393 | WORKER'S COMPENSATION # (01) | NY |