Individual
DR. ALLEN S. GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6128 BRANDON AVE STE 201, SPRINGFIELD, VA 22150-2693
(703) 780-2800
(703) 780-0461
Mailing address
6128 BRANDON AVE STE 201, SPRINGFIELD, VA 22150-2693
(703) 780-2800
(703) 780-0461
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101018446
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
088909
ANTHEM
VA
01
—
4089095
AETNA
VA
01
—
8132486
MAMSI
VA
01
—
95009502
UNITED HEALTHCARE
VA
01
—
B3800003
CAREFIRST BC/BS
VA
Enumeration date
09/02/2006
Last updated
03/29/2012
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