Provider Demographics
NPI:1326085606
Name:GAGLIARDI, GARY J (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:J
Last Name:GAGLIARDI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1519 HAZELWOOD CT E
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7850
Mailing Address - Country:US
Mailing Address - Phone:317-885-7609
Mailing Address - Fax:
Practice Address - Street 1:1481 W 10TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2803
Practice Address - Country:US
Practice Address - Phone:317-554-0181
Practice Address - Fax:317-554-0105
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01036779A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine