Individual
DR. GARY YOUNG
Active
Individual
DR. GARY YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD12211
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057221008
BCBS
—
05
—
077862
—
OR
01
—
104999
WA L & I
—
05
—
8280158
—
WA
01
—
A019
CHAMPUS
—
01
—
D70722
PROVIDENCE
—
05
—
XPY187524
—
CA
Enumeration date
05/25/2006
Last updated
12/19/2007
Update your record
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