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Individual

LEO M GAZONI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-0001
(434) 924-2047
Mailing address
PO BOX 405700, ATLANTA, GA 30384-6071
(804) 320-2751

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
0101248346
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116015691
VA

Other

Enumeration date
05/17/2007
Last updated
01/04/2022
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