Provider Demographics
NPI:1750918058
Name:HUFFMAN, GUNNAR (DO)
Entity type:Individual
Prefix:
First Name:GUNNAR
Middle Name:
Last Name:HUFFMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 NYETIMBER PKWY
Mailing Address - Street 2:
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-3148
Mailing Address - Country:US
Mailing Address - Phone:412-600-0719
Mailing Address - Fax:
Practice Address - Street 1:8 PIKES HL
Practice Address - Street 2:
Practice Address - City:NORWAY
Practice Address - State:ME
Practice Address - Zip Code:04268-5340
Practice Address - Country:US
Practice Address - Phone:207-744-6444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO3065207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine