Dr. Gary Fudem
Plastic and Reconstructive Surgery
325 9th Ave Department Of Plastic & Reconstructive Surgery
Seattle
, Washington 98104-2420
Dr. Gary Fudem
Plastic and Reconstructive Surgery
325 9th Ave Department Of Plastic & Reconstructive Surgery
Seattle
, Washington 98104-2420
(206) 543-6420
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About
Features
Specialties
- Plastic and Reconstructive Surgery
Languages spoken
- English
Location
First Address
- Dr. Gary Fudem
- Po Box 50095
- Seattle, WA
- Zip : 98145-5095
- Phone : (206) 543-6420
Second Address
- Dr. Gary Fudem
- 325 9th Ave Department Of Plastic & Reconstructive Surgery
- Seattle, WA
- Zip : 98104-2420
- Phone : (206) 744-5735
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0122X | Plastic and Reconstructive Surgery | MD60484351 | WA |
National Provider Identifier
| NPI | 1336123454 |
|---|---|
| Provider Name | Dr. Gary Fudem |
| First Address | Seattle, WA 98145-5095 |
| Second Address | Seattle, WA 98104-2420 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/12/2005 |
| Last Update Date | 17/12/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1336123454 | (05) | WA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.