Individual
MATTHEW BERNARD GAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19450 DEERFIELD AVE STE 200, LEESBURG, VA 20176-6821
(571) 209-1875
(703) 777-3365
Mailing address
224 D CORNWALL STREET NW, STE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101043432
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06403620
—
VA
05
—
1063408391
—
VA
05
—
30015898270001
—
VA
01
—
P00279876
RR MEDICARE
—
Enumeration date
09/22/2005
Last updated
02/07/2026
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