Provider Demographics
NPI:1558328534
Name:HO, GARRY W (MD)
Entity Type:Individual
Prefix:DR
First Name:GARRY
Middle Name:W
Last Name:HO
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:P. O. BOX 715868
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19171-5868
Mailing Address - Country:US
Mailing Address - Phone:804-215-3063
Mailing Address - Fax:804-968-1803
Practice Address - Street 1:8270 WILLOW OAKS CORP DRIVE
Practice Address - Street 2:SUITE 700
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4530
Practice Address - Country:US
Practice Address - Phone:703-810-5228
Practice Address - Fax:571-407-5659
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101236828207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1558328534Medicaid
VAI19201Medicare UPIN
DC015077F32Medicare PIN
VA1558328534Medicaid
I19201Medicare UPIN