Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. GARY BRIDGWATER, M.D.
Active Sole ProprietorDR. GARY BRIDGWATER, M.D. is a Specialist healthcare provider located in NISSWA, Minnesota. NPI 1477505204 is currently active in the NPPES registry. Verify at CMS.
Specialist · NISSWA, MN
Registration Details
- NPI Number
- 1477505204
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 17, 2006 (20.269163758736 yrs)
- Last Updated
- Mar 7, 2023
- License
-
56147 (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5898 NASHWAY RDNISSWA, MN, 564682358Browse MN providers · Browse ZIP 56468
- Phone
- 6083344812
- Primary Specialty
-
Specialist
174400000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.