MEDICARE: DR. NEAL S GAITHER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician	16632	WV
2	207RI0011X	Interventional Cardiology Physician	0101047289	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	C00075	OTHER	VA	MEDICARE GROUP
10	9318661	OTHER	WV	MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	502795	OTHER		NCPPO
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	082425	OTHER		SOUTHERN HEALTH
5	2119573	OTHER		MAMSI
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	44242	OTHER		COMMUNITYHEALTH SENTARA
9	030780	OTHER	VA	ANTHEM BCBS

General Provider Information

NPI Number	:	1003811563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEAL S GAITHER MD

Provider Business Mailing Address
First Line	:	220 CAMPUS BLVD STE 100
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22601-2896
Country	:	US
Telephone Number	:	540-536-5100
Fax Number	:	540-536-0235

Provider Business Practice Location Address
First Line	:	1880 AMHERST STREET
Second Line	:	SUITE 100 AND SUITE 200
City	:	WINCHESTER
State	:	VA
Zip	:	22601-2872
Country	:	US
Telephone Number	:	540-662-0306
Fax Number	:	855-264-2066

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	09/14/2021

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Directions to “ DR. NEAL S GAITHER MD” Practice Location

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