Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | MD25328 | OR |
N | 207RN0300X | Nephrologist | MD25328 | OR |
Y | 207RN0300X | Nephrologist | NE105493 | FL |
NPI | 1053323527 |
---|---|
Provider Name | Dr. Wesley Alan Gabbard |
First Address | Hudson, FL 34667 |
Second Address | Clearwater, FL 33761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 02/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001335100 | (05) | FL |
H4704CN763Z | (02) | FL |