Individual
BERIT L AMUNDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1415 S HWY 89, JACKSON, WY 83001-8515
(307) 739-8999
(307) 739-4811
Mailing address
PO BOX 428, JACKSON, WY 83001-0428
(307) 739-8999
(307) 739-4811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11180A
WY
207Q00000X
Family Medicine Physician
54338
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147069800
—
WY
Enumeration date
03/23/2010
Last updated
01/21/2021
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