Individual
AMANDA GUMBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
900 23RD ST NW STE G-2092, WASHINGTON, DC 20037-2342
(202) 715-4752
Mailing address
900 23RD ST NW STE G-2092, WASHINGTON, DC 20037-2342
(202) 715-4752
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
1678
OH
367H00000X
Anesthesiologist Assistant
Primary
1678
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1678
CERTIFICATE
OH
Enumeration date
07/11/2014
Last updated
01/11/2019
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