Provider Demographics
NPI:1184696742
Name:GARDNER, ARIC BRION (MD)
Entity type:Individual
Prefix:DR
First Name:ARIC
Middle Name:BRION
Last Name:GARDNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8525 ROLLING RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-3647
Mailing Address - Country:US
Mailing Address - Phone:703-393-1667
Mailing Address - Fax:703-393-2517
Practice Address - Street 1:8525 ROLLING RD
Practice Address - Street 2:SUITE 300
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-3647
Practice Address - Country:US
Practice Address - Phone:703-393-1667
Practice Address - Fax:703-393-2517
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0055198207X00000X
FLME103050207X00000X
NC2008-1028207X00000X
AZ41235207X00000X
DEC1-0009319207X00000X
NV13487207X00000X
VA0101248602207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVAA113192Medicare PIN
VAC09595Medicare PIN