Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 01083955A | IN |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 59157 | TN |
NPI | 1053739508 |
---|---|
Provider Name | Dr. Michael D Gabbard II |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Avon, IN 46123-6913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 17/02/2021 |