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NPI Code Detail

MEDICARE: DR. DAVID HENRY GARD MD

MEDICARE: DR. DAVID HENRY GARD 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
1208600000XSurgery PhysicianA37957CA

General Provider Information

NPI Number : 1316930019
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID HENRY GARD MD
Provider Business Mailing Address
First Line : P.O. BOX LBJ GENERAL DELIVERY
Second Line : LBJ TROPICAL MEDICAL CENTER
City : PAGO PAGO
State : AS
Zip : 96799
Country : US
Telephone Number : 684-633-1683
Fax Number : 684-633-1976
Provider Business Practice Location Address
First Line : 123 TURNER LANE
Second Line : LBJ TROPICAL MEDICAL CENTER
City : PAGO PAGO
State : AS
Zip : 96799
Country : US
Telephone Number : 684-633-1683
Fax Number : 684-633-1976
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2005
Last Update Date : 07/08/2007

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