Individual
DR. GARY FUDEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
325 9TH AVE, DEPARTMENT OF PLASTIC & RECONSTRUCTIVE SURGERY, SEATTLE, WA 98104-2420
(206) 744-5735
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
MD60484351
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336123454
—
WA
Enumeration date
12/01/2005
Last updated
12/17/2014
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