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Dr. Gary Bridgwater, MD
Specialist in Nisswa, Minnesota
NPI 1477505204

Gary Bridgwater is a Specialist based in Nisswa, MN. Gary Bridgwater practices in Nisswa, MN and has the professional credentials of MD. The NPI Number for Gary Bridgwater is 1477505204 and holds a License No. 56147 (Minnesota).

The current practice location address for Gary Bridgwater is 5898 Nashway Rd, Nisswa, MN and can be reached out via phone at 608-334-4812. You can also correspond with Gary Bridgwater through the mailing address at 5898 NASHWAY RD, NISSWA, MN - 56468-2358 (mailing address contact number: 608-334-4812).

Location: 5898 Nashway Rd, Nisswa, MN, 56468-2358
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1477505204
Provider Name
Gary Bridgwater
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
5898 Nashway Rd, Nisswa, MN, 56468-2358
Phone Number
608-334-4812
Fax Number
Provider Enumeration Date
05/17/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
19957 01 WI MEDICAL LICENSE
56147 01 MN MINNESOTA MEDICAL LICENSE
institution
Provider Business Practice Location Address Details
Address
5898 Nashway Rd
City
Nisswa
State
Minnesota
Zip
56468-2358
Phone Number
608-334-4812
Fax Number
person
Provider Business Mailing Address Details
Address
5898 Nashway Rd
City
Nisswa
State
Minnesota
Zip
56468-2358
Phone Number
608-334-4812
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
56147 (Minnesota)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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