Individual
MR. MICHAEL RUSSELL GANDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
721 MADISON ST SE, HUNTSVILLE, AL 35801-4408
(256) 880-6711
Mailing address
PO BOX 288, HUNTSVILLE, AL 35804-0288
(256) 880-6711
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1071312
AL
Other
Enumeration date
10/12/2006
Last updated
06/05/2014
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