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Individual

DR. BRIAN JOSEPH GAVITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD, MPH

Contact information

Practice address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
(937) 257-9517
(513) 558-3136
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5506
(513) 585-5511

Taxonomy

Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
35 129410
OH
2086S0102X
Surgical Critical Care Physician
A111684
CA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/21/2008
Last updated
12/04/2023
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