Healthcare Provider Details

I. General information

NPI: 1851466478
Provider Name (Legal Business Name): DAVID WAYNE GAGER M.S.,CCC-A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 10/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 A JONES RD.
FALMOUTH MA
02540-2908
US

IV. Provider business mailing address

200 A JONES RD.
FALMOUTH MA
02540-2908
US

V. Phone/Fax

Practice location:
  • Phone: 508-540-0900
  • Fax:
Mailing address:
  • Phone: 508-540-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number904
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: