MEDICARE: ANDREW GEORGE GUNTHER M.D.

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	204C00000X	Sports Medicine (Neuromusculoskeletal Medicine) Physician	169393	NY
2	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	169393	NY
3	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	169393	NY
4	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	169393	NY
5	207XX0801X	Orthopaedic Trauma Physician	169393	NY
6	207X00000X	Orthopaedic Surgery Physician	169393	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10000823	OTHER	NY	CDPHP
2	OS 169393	OTHER	NY	WORKER'S COMPENSATION #

General Provider Information

NPI Number	:	1245267913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW GEORGE GUNTHER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 14890
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12212-4890
Country	:	US
Telephone Number	:	518-525-5634
Fax Number	:	518-649-4094

Provider Business Practice Location Address
First Line	:	315 2ND AVE
Second Line	:
City	:	TROY
State	:	NY
Zip	:	12182-3237
Country	:	US
Telephone Number	:	518-237-7033
Fax Number	:	518-237-4314

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

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	05/21/2021

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