Individual
TIMOTHY JOHN GARDNER
Active
Individual
TIMOTHY JOHN GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00019722
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10002943
BS OF IDAHO
—
05
—
8457202
—
WA
01
—
GA5801
AZURIS
—
Enumeration date
10/14/2005
Last updated
01/25/2010
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