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Individual
EDWARD L. GUMM
Active
Individual
EDWARD L. GUMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA274
KY
363AM0700X
Medical Physician Assistant
PA274
KY
363AS0400X
Surgical Physician Assistant
PA274
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36000818
ASC MEDICAID GROUP
KY
01
—
37903705
MEDICAID LAB GROUP
KY
01
—
4000501
MEDICARE LAB GROUP
KY
05
—
95001277
—
KY
01
—
ASC1019
ASC MEDICARE GROUP
KY
01
—
CB5773
RR MEDICARE GROUP
KY
Enumeration date
10/04/2006
Last updated
11/02/2007
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