Provider Demographics
NPI:1003811563
Name:GAITHER, NEAL S (MD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:S
Last Name:GAITHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:220 CAMPUS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2896
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:540-536-0235
Practice Address - Street 1:1880 AMHERST STREET
Practice Address - Street 2:SUITE 100 AND SUITE 200
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2872
Practice Address - Country:US
Practice Address - Phone:540-662-0306
Practice Address - Fax:855-264-2066
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16632207RI0011X
VA0101047289207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006048463Medicaid
502795OtherNCPPO
WV0074126000Medicaid
082425OtherSOUTHERN HEALTH
2119573OtherMAMSI
MD754451100Medicaid
44242OtherCOMMUNITYHEALTH SENTARA
VAC00075OtherMEDICARE GROUP
VA030780OtherANTHEM BCBS
WV9318661OtherMEDICARE GROUP
VA030780OtherANTHEM BCBS
502795OtherNCPPO
44242OtherCOMMUNITYHEALTH SENTARA
VA006048463Medicaid