PRESTON ALDEN GARDNER (NPI# 1861784449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861784449 |
| Entity Type | Individual |
| Full Name | PRESTON ALDEN GARDNER |
| Credential | D.O. |
| Practice Address |
7881 Carnegie Blvd Fort Wayne IN 46804 |
| Mailing Address |
7881 Carnegie Blvd Fort Wayne IN 46804-5792 |
| Practice Telephone | 2604368000 |
| Practice Fax Number | 2604325587 |
| Mailing Telephone | 2604368000 |
| Mailing Fax Number | 2604325587 |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2019-04-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 5101019137 | MI | Allopathic & Osteopathic Physicians |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
02005587A | IN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 28050 Grand River Ave, Farmington Hills, MI 483365919 | 3365093316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326574807 | Preston Gardner | Peer Specialist | 2901 E Burnside St, Portland, OR 97214-1831 | 2017-05-03 |
| Street Address |
7881 CARNEGIE BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730277583 | Fort Wayne Dermatology Cons. Inc. | Plastic Surgery | 7881 Carnegie Blvd, Fort Wayne, IN 46804-5792 | 2006-10-10 |
| 1568727345 | Hany Osman | Pathology | 7881 Carnegie Blvd, Fort Wayne, IN 46804 | 2012-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366754616 | Darnell J Brown | Surgery | 700 Broadway, Fort Wayne, IN 46802-1402 | 2010-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982050340 | Eric Pittelkow | Surgery | 545 Barnhill Drive Emerson Hall, Suite 232, Indianapolis, IN 46202 | 2016-05-04 |
| 1639577794 | Petrungaro Plastic Surgery, LLC | Surgery | 800 Macarthur Blvd Ste 21, Munster, IN 46321-2918 | 2014-12-05 |
| 1164654257 | Erin Weber | Surgery | 1801 N Senate Blvd Ste 525, Indianapolis, IN 46202-1253 | 2009-08-21 |
| 1801036132 | Sholar Center for Aesthetic Surgery | Surgery | 445 Cross Pointe Blvd., Suite 230, Evansville, IN 44715-4013 | 2009-02-26 |
| 1013164425 | Dawn M Burgess | Surgery | 2701 Lincoln Ave, Evansville, IN 47714-1627 | 2008-08-27 |
| 1669677142 | Jaime Marie Ranieri | Surgery | 8051 S Emerson Ave Ste 450, Indianapolis, IN 46237-8667 | 2007-06-15 |
| 1770708158 | Kimberly K Short | Surgery | 8455 Clearvista Place, Indianapolis, IN 46256-2419 | 2007-04-13 |
| 1780770255 | Belarmino T Frogozo | Surgery | 501 E Hospital Ln Ste 107, Terre Haute, IN 47802-4230 | 2006-10-04 |
| 1740223510 | Elizabeth A Grasee | Surgery | 12425 Old Meridian St, Suite #b1, Carmel, IN 46032-8724 | 2006-06-13 |
| 1578517553 | Robert E Frank | Surgery | 931 Ridge Rd, Suite A, Munster, IN 46321-1755 | 2006-05-22 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46804 |
Please comment or provide details below to improve the information on PRESTON ALDEN GARDNER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.