Provider Demographics
NPI:1710305966
Name:DOGAL GARDNER, NATALIE M
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:M
Last Name:DOGAL GARDNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 HUNTINGDON PIKE STE 118
Mailing Address - Street 2:
Mailing Address - City:MEADOWBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19046-8005
Mailing Address - Country:US
Mailing Address - Phone:215-914-2600
Mailing Address - Fax:215-938-9818
Practice Address - Street 1:1650 HUNTINGDON PIKE STE 118
Practice Address - Street 2:
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046-8005
Practice Address - Country:US
Practice Address - Phone:215-914-2600
Practice Address - Fax:215-938-9818
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101264675207V00000X
PAMD479808207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology