Provider Demographics
NPI:1447496880
Name:RICHARD C. GUNTER, CRNA,PA
Entity type:Organization
Organization Name:RICHARD C. GUNTER, CRNA,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:410-430-3513
Mailing Address - Street 1:936 TURNSTONE CIR
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-9331
Mailing Address - Country:US
Mailing Address - Phone:410-430-3513
Mailing Address - Fax:443-736-7574
Practice Address - Street 1:936 TURNSTONE CIR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-9331
Practice Address - Country:US
Practice Address - Phone:410-430-3513
Practice Address - Fax:443-736-7574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR056725367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD547LMedicare PIN