Provider Demographics
NPI:1659367092
Name:GUNTER, RICHARD C (CRNA)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:C
Last Name:GUNTER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR056725367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD547L738CMedicare PIN
MD547LMedicare ID - Type Unspecified