Individual
WILLIAM C GAINEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 WASHINGTON AVE, PHILADELPHIA, PA 19147-4335
(843) 731-2837
Mailing address
1 WASHINGTON AVE, PHILADELPHIA, PA 19147-4335
(843) 731-2837
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1364831311
TRI CARE
CA
Enumeration date
05/24/2022
Last updated
05/24/2022
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