Healthcare Provider Details

I. General information

NPI: 1750918058
Provider Name (Legal Business Name): GUNNAR HUFFMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 10/13/2023
Certification Date: 10/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 PIKES HL
NORWAY ME
04268-5340
US

IV. Provider business mailing address

118 NYETIMBER PKWY
MOON TOWNSHIP PA
15108-3148
US

V. Phone/Fax

Practice location:
  • Phone: 207-744-6444
  • Fax:
Mailing address:
  • Phone: 412-600-0719
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDO3065
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: