Individual
DR. BRETT MATTHEW GUDGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
11685097-1205
UT
207W00000X
Ophthalmology Physician
32820
OK
207W00000X
Ophthalmology Physician
Primary
MD205372
OR
390200000X
Student in an Organized Health Care Education/Training Program
11018880A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500794640
—
OR
01
—
R227471
MEDICARE
OR
Enumeration date
06/16/2016
Last updated
11/17/2021
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