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Individual

DR. KENNETH STUART GERWIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
718 SMYTH RD, MANCHESTER, NH 03104-7004
(603) 624-4366
Mailing address
4 KISSEL LN, MORRISTOWN, NJ 07960-3613
(973) 267-6891
(973) 605-5990

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
24091
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
24091
MEDICAL LICENSE
NJ
Enumeration date
08/24/2006
Last updated
07/08/2007
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