MEDICARE: RJ GAMAD M.D.,P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME0021270	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568430965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RJ GAMAD M.D.,P.A.

Provider Business Mailing Address
First Line	:	3232 E 15TH ST
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-7423
Country	:	US
Telephone Number	:	850-769-1533
Fax Number	:	850-785-1189

Provider Business Practice Location Address
First Line	:	3232 E 15TH ST
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-7423
Country	:	US
Telephone Number	:	850-769-1533
Fax Number	:	850-785-1189

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	10/28/2014

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Practice Fax: 850-785-1189

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