Provider Demographics
NPI:1215710512
Name:GARDNER, ROBERT CHRISTOPHER
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHRISTOPHER
Last Name:GARDNER
Suffix:
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 1:14000 CASTLE BLVD APT 1005
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-4642
Mailing Address - Country:US
Mailing Address - Phone:301-852-6158
Mailing Address - Fax:
Practice Address - Street 1:6918 WILLOW ST NW APT 301
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2234
Practice Address - Country:US
Practice Address - Phone:202-361-9370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant