Gagarin, Dmitri Andreyevich
Gagarin, Dmitri Andreyevich is an individual health care provider with primary practice located at 16000 Johnston Memorial Dr Fl 4 , Abingdon VA 24211-7664. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Gagarin, Dmitri Andreyevich can be contacted via phone (276) 258-1000.Contact Information
Primary practice address
16000 Johnston Memorial Dr Fl 4
Abingdon VA 24211-7664
Phone: (276) 258-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 2081H0002X | D0082658 | Maryland |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 35.096436 | Ohio |
Profile Details
| NPI number | 1114109089 |
|---|---|
| LBN Legal business name | Gagarin, Dmitri Andreyevich |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 3rd, 2007 |
| Last updated | Nov 28th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114109089 | NPPES |
| Ohio | MEDICAID | 3139008 |
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