Individual
DR. MICHAEL RAY GUMMOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3225 INDEPENDENCE RD, CANON CITY, CO 81212-9380
(719) 275-2351
Mailing address
3225 INDEPENDENCE RD, CANON CITY, CO 81212-9380
(719) 275-2351
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
48133
CO
2084P0804X
Child & Adolescent Psychiatry Physician
R-7895
IA
Other
Enumeration date
12/04/2006
Last updated
09/06/2012
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