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Individual

DR. STEVEN R GAMBERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-5793
(410) 328-0248
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-5793
(410) 328-0248

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D54005
MD
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
D54005
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110212579
R/R MEDICARE PROVIDER #
MD
01
607639-03 & 04
BLUE CROSS/BLUE SHIELD
MD
05
970502300
MD
01
CC3778
R/R MEDICARE GROUP #
MD
01
S062-0357
BLUE CROSS/BLUE SHIELD - REGIONAL
MD
Enumeration date
05/12/2006
Last updated
07/12/2011
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