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Individual
DR. MARK R GUNDERSEN
Active
Individual
DR. MARK R GUNDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35677
MN
207Q00000X
Family Medicine Physician
4301069187
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010G56026
HEALTH PLUS
MI
01
—
080093188
METRAHEALTH
MI
01
—
0802502771
BLUE CROSS BLUE SHIELD
MI
01
—
080D410020
BLUE CROSS BLUE SHIELD
MI
01
—
204375
MCLAREN HEALTH PLAN
MI
05
—
4540600
—
MI
01
—
5659321
AETNA
MI
01
—
7073962004
CIGNA
MI
01
—
C4258
MCARE
MI
01
—
F31478
HEALTH NET FEDERAL
MI
Enumeration date
10/20/2005
Last updated
10/29/2019
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