Gardner, James Douglas

Gardner, James Douglas is an individual health care provider with primary practice located at 1351 Westgate Center Dr , Winston Salem NC 27103-2934. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Gardner, James Douglas can be contacted via phone (336) 718-7777.

Contact Information

Primary practice address
1351 Westgate Center Dr Winston Salem NC 27103-2934
Fax: (336) 718-7744
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0096-01612 North Carolina

Profile Details

NPI number 1962473231
LBN Legal business name Gardner, James Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated Dec 23rd, 2021 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962473231 NPPES
North Carolina MEDICAID 891027X

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