Individual
DAVID A GORTNER
Active
Individual
DAVID A GORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
44295
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039581
LABOR & INDUSTRY
WA
01
—
110170999
RAILROAD MEDICARE
WA
05
—
8263105
—
WA
01
—
G455
BLUE SHIELD
WA
01
—
MD434WA
ALASKA MEDICAID
WA
01
—
US0899780
AETNA/USHC SPECIALIST
WA
Enumeration date
07/21/2006
Last updated
05/19/2015
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