Individual
GARREN P. GEBHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
435 SOUTH ST STE 160, MORRISTOWN, NJ 07960-6477
(973) 971-6301
(973) 290-7169
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(844) 362-1735
(973) 290-7495
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
02003217A
IN
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
25MB11977300
NJ
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
7091
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000552067
ANTHEM
IN
01
—
030371536
CIGNA PPO
VT
01
—
093299
SIHO
IN
01
—
1I4071
MEDICARE
OK
05
—
200939790A
—
OK
05
—
201269220
—
IN
01
—
49712
BLUE CROSS/BLUE SHIELD
VT
01
—
6961878
CIGNA HMO
VT
01
—
7365329
AETNA
IN
01
—
PO1457038
RAIL ROAD PTAN
IN
Enumeration date
05/04/2006
Last updated
02/05/2024
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