Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 0101035749 | VA |
NPI | 1326051889 |
---|---|
Provider Name | Harry Lewis Gewanter |
First Address | Richmond, VA 23291-1734 |
Second Address | Richmond, VA 23219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 28/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F76371 | (02) |