Individual
DR. GARY MICHAEL VITA
Active
Individual
DR. GARY MICHAEL VITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D0046107
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050063100
RAILROAD MEDICARE
MD
05
—
160131800
—
MD
01
—
4E67000004
FEDERAL BCBS
—
01
—
53351803
BCBS
—
Enumeration date
10/27/2006
Last updated
06/11/2021
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