Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 54450 | TN |
Y | 2080P0208X | Pediatric Infectious Diseases | 54450 | TN |
N | 2080P0208X | Pediatric Infectious Diseases | MD466866 | PA |
NPI | 1538503412 |
---|---|
Provider Name | Patrick Joseph Gavigan |
First Address | Hershey, PA 17033-0855 |
Second Address | Hershey, PA 17033-2360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2013 |
Last Update Date | 29/12/2020 |