MEDICARE: DR. MARGARITA HAUSER GARDINER 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	207R00000X	Internal Medicine Physician	MD037949E	PA
2	207RR0500X	Rheumatology Physician	MD037949E	PA

General Provider Information

NPI Number	:	1376812909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARGARITA HAUSER GARDINER MD

Provider Business Mailing Address
First Line	:	8512 PARKWOOD LN
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19128-1309
Country	:	US
Telephone Number	:	215-508-0765
Fax Number	:	215-508-0764

Provider Business Practice Location Address
First Line	:	8512 PARKWOOD LN
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19128-1309
Country	:	US
Telephone Number	:	215-508-0765
Fax Number	:	215-508-0764

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

Provider Enumeration Date	:	12/28/2011
Last Update Date	:	12/28/2011

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