Gardner, Richard Charles
Gardner, Richard Charles is an individual health care provider with primary practice located at 77 Mass Ave Mit Medical Dept Rm 23 215, Cambridge MA 02139-4301. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Gardner, Richard Charles can be contacted via phone (617) 253-1681.Contact Information
Primary practice address
77 Mass Ave Mit Medical Dept Rm 23 215
Cambridge MA 02139-4301
Phone: (617) 253-1681
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 29590 | Massachusetts |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 29590 | Massachusetts |
Profile Details
| NPI number | 1851381420 |
|---|---|
| LBN Legal business name | Gardner, Richard Charles |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 25th, 2005 |
| Last updated | May 9th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851381420 | NPPES |
| Massachusetts | MEDICAID | 0130745 |
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