Provider Demographics
NPI:1376696435
Name:GAITONDE, MICHAEL N (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:N
Last Name:GAITONDE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7310 HERITAGE VILLAGE PLZ
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3303
Mailing Address - Country:US
Mailing Address - Phone:571-248-6488
Mailing Address - Fax:
Practice Address - Street 1:7310 HERITAGE VILLAGE PLZ
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3303
Practice Address - Country:US
Practice Address - Phone:571-248-6488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556082111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAU91258Medicare UPIN
VAG00954Medicare ID - Type Unspecified