Individual
KENNETH W GERARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7915 LAKE MANASSAS DR, STE 302, GAINESVILLE, VA 20155-3260
(571) 248-0653
Mailing address
11781 LEE JACKSON MEMORIAL HWY, STE 550, FAIRFAX, VA 22033-3309
(571) 777-5106
(703) 563-6256
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
C1-0003259
DE
207L00000X
Anesthesiology Physician
Primary
ME96504
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276470900
—
FL
01
—
56538
BCBSFL
FL
Enumeration date
07/07/2006
Last updated
12/04/2015
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