Individual
GORDON L AVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1635 N GEORGE MASON DR, SUITE 310, ARLINGTON, VA 22205-3616
(703) 810-5215
(703) 810-5428
Mailing address
PO BOX 75868, BALTIMORE, MD 21275-5868
(703) 383-6469
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101031957
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6404880
—
VA
01
—
P00151206
MEDICARE RAILROAD
—
Enumeration date
07/18/2006
Last updated
10/26/2020
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