Provider Demographics
NPI:1205006772
Name:GUNTER, AMBER K (OD)
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:K
Last Name:GUNTER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 E STUART DR
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-2514
Mailing Address - Country:US
Mailing Address - Phone:276-236-4171
Mailing Address - Fax:276-236-0909
Practice Address - Street 1:1102 E STUART DR
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2514
Practice Address - Country:US
Practice Address - Phone:276-236-4171
Practice Address - Fax:276-236-0909
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001708152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1649206814OtherGROUP NPI