MEDICARE: MORGAN ANN GARDNER 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	208000000X	Pediatrics Physician	4301505940	MI
2	208000000X	Pediatrics Physician	2020-00265	NC
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1477085058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN ANN GARDNER MD

Provider Business Mailing Address
First Line	:	2005 PISGAH CHURCH RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-3309
Country	:	US
Telephone Number	:	336-716-9150
Fax Number	:	336-702-9166

Provider Business Practice Location Address
First Line	:	2005 PISGAH CHURCH RD
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27455-3309
Country	:	US
Telephone Number	:	336-716-9150
Fax Number	:	336-702-9166

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

Provider Enumeration Date	:	04/01/2017
Last Update Date	:	11/24/2025

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