Provider Demographics
NPI:1215048673
Name:GARDNER, ALAN M (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:M
Last Name:GARDNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2550 WINDY HILL RD SE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8665
Mailing Address - Country:US
Mailing Address - Phone:770-952-2100
Mailing Address - Fax:770-850-9712
Practice Address - Street 1:2550 WINDY HILL RD SE
Practice Address - Street 2:SUITE 220
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8665
Practice Address - Country:US
Practice Address - Phone:770-952-2100
Practice Address - Fax:770-850-9712
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2012-08-28
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Provider Licenses
StateLicense IDTaxonomies
GA027191207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology