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Individual
MICHAEL W GAUDERER
Active
Individual
MICHAEL W GAUDERER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
17609
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265047
CIGNA
SC
05
—
176099
—
SC
01
—
4007279
AETNA
SC
01
—
57-6007863046
BCBS OF SC
SC
Enumeration date
06/14/2006
Last updated
12/11/2009
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