Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 0101262524 | VA |
N | 207X00000X | Orthopaedic Surgeon | 286998 | NY |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 0101262524 | VA |
NPI | 1508124439 |
---|---|
Provider Name | Dr. Conor Brendan Garry |
First Address | South Boston, VA 24592-5200 |
Second Address | Portsmouth, VA 23708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2012 |
Last Update Date | 03/12/2020 |