Gardner, Mark A

Gardner, Mark A is an individual health care provider with primary practice located at 510 Butler Ave , Martinsburg WV 25405-9990. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Sports Medicine, which is considered as his primary health care specialty. Gardner, Mark A can be contacted via phone (304) 263-0811.

Contact Information

Primary practice address
510 Butler Ave Martinsburg WV 25405-9990
Phone: (304) 263-0811
Fax: (800) 817-3807
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Sports Medicine 213ES0000X 0103000917 Virginia

Profile Details

NPI number 1336131473
LBN Legal business name Gardner, Mark A
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2005
Last updated Nov 25th, 2020 - about 4 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 1336131473 NPPES
Virginia Other 115888 ANTHEM BC/BS
Virginia Other 1215628 ANTHEM BC/BS
Virginia Other 65326 ANTHEM BC/BS

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