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1801883822

NPI Code Detail

MEDICARE: DR. AVTAR T GHUMAN MD

MEDICARE: DR. AVTAR T GHUMAN MD

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	207W00000X	Ophthalmology Physician	ME0080678	FL
2	208000000X	Pediatrics Physician	ME0080678	FL
3	207WX0107X	Retina Specialist (Ophthalmology) Physician	ME80678	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CA7010	OTHER	FL	RAILROAD MEDICARE GROUP
4	180041380	OTHER	FL	RAILROAD MEDICARE

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801883822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AVTAR T GHUMAN MD

Provider Business Mailing Address
First Line	:	6901 INTERNATIONAL CENTER BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-7125
Country	:	US
Telephone Number	:	239-939-4323
Fax Number	:	239-939-3983

Provider Business Practice Location Address
First Line	:	6901 INTERNATIONAL CENTER BLVD
Second Line	:
City	:	FT MYERS
State	:	FL
Zip	:	33912-7125
Country	:	US
Telephone Number	:	239-939-4323
Fax Number	:	239-939-3983

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	12/01/2017

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Practice Location Address:

6901 INTERNATIONAL CENTER BLVD
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1497714422 — DR. GLENN L WING M.D.
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6901 INTERNATIONAL CENTER BLVD
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1306806641 — DR. JOSEPH P WALKER M.D.
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Practice Fax: 239-939-3983

1255369526 — DR. ASHISH G SHARMA MD
Practice Location Address:

6901 INTERNATIONAL CENTER BLVD
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33912-7125

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Practice Location Address:

6901 INTERNATIONAL CENTER BLVD
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1326823436 — RAISA DIAZ GUERRERO
Practice Location Address:

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Practice Fax:

Directions to “ DR. AVTAR T GHUMAN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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