Individual
DR. MICHAEL GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1973 WASHINGTON VALLEY RD, MARTINSVILLE, NJ 08836-2053
(732) 560-9225
(732) 560-8095
Mailing address
PO BOX 416457, BOSTON, MA 02241-2053
(844) 362-1735
(973) 290-7495
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA09511000
NJ
Other
Enumeration date
06/06/2014
Last updated
09/07/2023
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