Gardner, Brian
Gardner, Brian is an individual health care provider with primary practice located at 1215 Lee St Box 800719, Charlottesville VA 22908-0816. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Gardner, Brian can be contacted via phone (434) 924-2150.Contact Information
Primary practice address
1215 Lee St Box 800719
Charlottesville VA 22908-0816
Phone: (434) 924-2150
Fax: (434) 982-1530
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 82070 | South Carolina |
Profile Details
| NPI number | 1356785455 |
|---|---|
| LBN Legal business name | Gardner, Brian |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 19th, 2013 |
| Last updated | Oct 7th, 2019 - about 5 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 | 1356785455 | NPPES |
| South Carolina | MEDICAID | 820703 | |
| South Carolina | Other | SCF2284467 |
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