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Individual
DR. MICHAEL BRUCE GENTRY
Active
Individual
DR. MICHAEL BRUCE GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0392
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003926
—
SC
01
—
P00015070
RAILROAD MEDICARE
SC
Enumeration date
05/31/2005
Last updated
03/07/2011
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