Healthcare Provider Details

I. General information

NPI: 1508078635
Provider Name (Legal Business Name): NADIA GAAFAR GARD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NADIA ANN GAAFAR MD

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4910 VALLEY VIEW BLVD N W SUITE 310
ROANOKE VA
24012
US

IV. Provider business mailing address

4910 VALLEY VIEW BLVD N W SUITE 310
ROANOKE VA
24012
US

V. Phone/Fax

Practice location:
  • Phone: 540-362-0360
  • Fax: 540-366-5590
Mailing address:
  • Phone: 540-362-0360
  • Fax: 540-366-5590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101236618
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: