Individual
GARY M WARSTADT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1093 N MAIN ST, RANDOLPH, MA 02368
(781) 963-7775
(781) 963-7776
Mailing address
1093 N MAIN ST, RANDOLPH, MA 02368
(781) 963-7775
(781) 963-7776
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
57569
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3019454
—
MA
Enumeration date
12/19/2005
Last updated
07/12/2016
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