Gavin, Matthew Bernard

Gavin, Matthew Bernard is an individual health care provider with primary practice located at 224-D Cornwall Street, Nw, Suite 204, , Leesburg VA 20176-2700. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Gavin, Matthew Bernard can be contacted via phone (703) 777-3262.

Contact Information

Primary practice address
224-D Cornwall Street, Nw, Suite 204, Leesburg VA 20176-2700
Phone: (703) 777-3262
Fax: (703) 777-3365
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 0101043432 Virginia

Profile Details

NPI number 1063408391
LBN Legal business name Gavin, Matthew Bernard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2005
Last updated Mar 19th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063408391 NPPES
Virginia MEDICAID 30015898270001
Virginia MEDICAID 06403620
Virginia MEDICAID 1063408391
Virginia Other P00279876

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