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NPI Code Detail

MEDICARE: JASON GUNN

MEDICARE: JASON GUNN
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
1207RC0200XCritical Care Medicine (Internal Medicine) Physician2014-01042NC
2207RP1001XPulmonary Disease Physician31487SC
3207RC0200XCritical Care Medicine (Internal Medicine) Physician31487SC

Other Identifiers

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

General Provider Information

NPI Number : 1386760080
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON GUNN
Provider Business Mailing Address
First Line : 125 DOUGHTY ST STE 200
Second Line :
City : CHARLESTON
State : SC
Zip : 29403-5727
Country : US
Telephone Number : 843-577-6791
Fax Number : 843-577-0553
Provider Business Practice Location Address
First Line : 125 DOUGHTY ST STE 200
Second Line :
City : CHARLESTON
State : SC
Zip : 29403-5727
Country : US
Telephone Number : 843-577-6791
Fax Number : 843-577-0553
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2007
Last Update Date : 11/20/2020

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Directions to “ JASON GUNN ” Practice Location

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