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Individual
JERAD MICHAEL GARDNER
Active
Individual
JERAD MICHAEL GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
E7425
AR
207ZD0900X
Dermatopathology (Pathology) Physician
N5684
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
E7425
AR
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
TMD004672
PA
Other
Enumeration date
12/20/2008
Last updated
05/28/2020
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