Individual
DR. LARISA P GAVRILOVA-JORDAN
Active
Individual
DR. LARISA P GAVRILOVA-JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
2006-00745
NC
207V00000X
Obstetrics & Gynecology Physician
46727
MN
207VE0102X
Reproductive Endocrinology Physician
Primary
70748
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5909224
—
NC
05
—
891448600
—
MN
Enumeration date
01/11/2006
Last updated
06/24/2019
Update your record
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