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General NPI Number Information
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NPI Number | 1720031446
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Entity Type | Individual
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Provider Name | GARY M AMUNDSON MD
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Gender | Male
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 01/24/2013
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Provider Practice Location Address
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Address Line | 750 E ADAMS ST
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City | SYRACUSE
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State | NY
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Zip | 13210-2342
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Country | US
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Telephone | 315-464-7433
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Fax |
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Provider Business Mailing Address
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Address Line | 750 E ADAMS ST
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City | SYRACUSE
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State | NY
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Zip | 13210-2342
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Country | US
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Telephone | 316-464-7433
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | MD420848
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | 46808-020
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | 21983
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License Number State | NE
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Taxonomy #4
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | 42387
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License Number State | MN
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Taxonomy #5
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | 4301053830
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | 35.043846
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License Number State | OH
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Taxonomy #7
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | 28490
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License Number State | SC
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Taxonomy #8
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | MD00047561
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License Number State | WA
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Taxonomy #9
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | 41082
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License Number State | KY
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