Individual
TIMOTHY ANDREW GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
20515
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240082
MIDLANDS CHOICE
NE
01
—
34032
BCBS
NE
05
—
47017633037
—
NE
Enumeration date
07/29/2005
Last updated
11/10/2023
Update your record
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