Provider Demographics
NPI:1851728539
Name:FLEETWOOD, IAN GORDON (MD, BSC, BSC(MED))
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:GORDON
Last Name:FLEETWOOD
Suffix:
Gender:M
Credentials:MD, BSC, BSC(MED)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 DISCOVERY STREET
Mailing Address - Street 2:CBI HEALTH CENTRE - 2ND FLOOR
Mailing Address - City:VICTORIA
Mailing Address - State:BRITISH COLUMBIA (BC)
Mailing Address - Zip Code:V8T 5G4
Mailing Address - Country:CA
Mailing Address - Phone:1250-383-3638
Mailing Address - Fax:1250-383-3638
Practice Address - Street 1:605 DISCOVERY STREET
Practice Address - Street 2:CBI HEALTH CENTRE - 2ND FLOOR
Practice Address - City:VICTORIA
Practice Address - State:BRITISH COLUMBIA (BC)
Practice Address - Zip Code:V8T 5G4
Practice Address - Country:CA
Practice Address - Phone:1250-383-3638
Practice Address - Fax:1250-383-3638
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72284282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital