Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 242447 | NY |
N | 208600000X | Surgeon | 242447 | NY |
Y | 2086S0120X | Pediatric Surgery | 0101256920 | VA |
NPI | 1497918957 |
---|---|
Provider Name | Jeffrey W. Gander |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22908-0816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2008 |
Last Update Date | 02/10/2014 |