Provider Demographics
NPI:1588814081
Name:GAZAWAY, PRESTON MANN III
Entity Type:Individual
Prefix:DR
First Name:PRESTON
Middle Name:MANN
Last Name:GAZAWAY
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9712 BELAIR RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-1103
Mailing Address - Country:US
Mailing Address - Phone:410-248-3245
Mailing Address - Fax:410-248-3248
Practice Address - Street 1:9712 BELAIR RD
Practice Address - Street 2:SUITE 301
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-1103
Practice Address - Country:US
Practice Address - Phone:410-248-3245
Practice Address - Fax:410-248-3248
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD27095207VB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VB0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObesity Medicine