Provider Demographics
NPI:1356451447
Name:GUNN, PATRICK W (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:W
Last Name:GUNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 MOUNTAIN STREET
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-2138
Mailing Address - Country:US
Mailing Address - Phone:775-885-2229
Mailing Address - Fax:775-882-5045
Practice Address - Street 1:1200 MOUNTAIN STREET
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-2138
Practice Address - Country:US
Practice Address - Phone:775-885-2229
Practice Address - Fax:775-882-5045
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV6504208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics