Basic Information
| Provider Information | |||||||||
| NPI: | 1992822746 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARVIN | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | PATRICK | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GARVIN | ||||||||
| OtherFirstName: | BRIAN | ||||||||
| OtherMiddleName: | PATRICK | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 191 BILTMORE AVE | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288014109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282540881 | ||||||||
| FaxNumber: | 8283503026 | ||||||||
| Practice Location | |||||||||
| Address1: | 191 BILTMORE AVE | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288014109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282540881 | ||||||||
| FaxNumber: | 8283503026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2007 | ||||||||
| LastUpdateDate: | 09/24/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 2012-01419 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 1992822746 | 01 | NC | MEDCOST | OTHER | FG2480919 | 01 | NC | DEA | OTHER | 1992822746 | 01 | NC | BCBSNC | OTHER | 5922102 | 05 | NC | MEDICAID |