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General NPI Number Information
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NPI Number | 1528039054
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Entity Type | Individual
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Provider Name | JAMES MATTHEW GARDNER MD
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Gender | Male
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 1510 N 28TH ST STE 101
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City | RICHMOND
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State | VA
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Zip | 23223-5311
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Country | US
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Telephone | 804-521-0050
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Fax | 833-973-3890
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Provider Business Mailing Address
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Address Line | 1510 N 28TH ST STE 101
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City | RICHMOND
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State | VA
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Zip | 23223-5311
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Country | US
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Telephone | 804-521-0050
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Fax | 833-973-3890
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 0101049730
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License Number State | VA
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