NPI 1316189608

Gavin Blair Gore

Practitioner Diagnostic Radiology Physician Leesburg, VA

Practice location

Address: 19500 Sandridge Way, Suite 420, Leesburg, VA 20176-3467
Phone: (571) 375-8601
Fax: (571) 223-6773
Mailing address: 224-D Cornwall Street, NW, Suite 403, Leesburg, VA 20176-2704

Registered specialties (3)

Diagnostic Radiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence 0101258174 (VA)

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Diagnostic Radiology Physician

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence 2013-02510 (NC)

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1316189608
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Apr 2009
Record last updated: 29 Nov 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.