Kahlil Ashley Gaiters, DO
Family Medicine in Manassas, VA. Individual provider (NPI-1).
NPI number1982257960
StatusActive
Last updated in NPPESJan 27, 2023
Details
- NPI
- 1982257960
- Entity type
- Individual (NPI-1)
- Name
- Kahlil Ashley Gaiters
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 19, 2019
- Certification date
- Aug 17, 2022
- Last updated
- Jan 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 0102207285 | VA | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | 0116033462 | VA |
Practice location
10945 George Mason Cir Ste 105Manassas, VA 20110-2233
Phone 703-361-5116 · Fax 571-364-8911
Mailing address
Po Box 936952Atlanta, GA 31193-6952
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