Individual
DR. BRIAN GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1215 LEE ST, BOX 800719, CHARLOTTESVILLE, VA 22908-0816
(434) 924-2150
(434) 982-1530
Mailing address
1215 LEE ST, BOX 800719, CHARLOTTESVILLE, VA 22908-0816
(434) 924-2150
(434) 982-1530
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
82070
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
820703
—
SC
01
—
SCF2284467
SC MEDICARE
SC
Enumeration date
04/19/2013
Last updated
10/07/2019
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