Gary Penner
Gary Penner is a Family Medicine Physician in Fairfax, Virginia. Licensed in Nebraska and Virginia. Registered with an NPI since 2006.
- Licensed in
- NE, VA
- In the registry since
- 2006
- Specialties on file
- 2
Practice location Address checks out
11910 Parkside DrFairfax, VA 22033-2648
Phone: (202) 816-2832
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X · Licence 0101027481 (VA) |
|---|---|
| Family Medicine Physician | Taxonomy 207Q00000X · Licence 12875 (NE) |
Record details
| NPI number | 1689740136 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | November 27, 2006 |
| Last updated in NPPES | March 8, 2022 |
| Certification date | March 8, 2022 |
| Mailing address | 11910 Parkside Dr, Fairfax, VA 22033-2648 |
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