Individual
DR. MARK CLYDE GEBHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
330 BROOKLINE AVE, BIDMC - STONEMAN 10, BOSTON, MA 02215-5400
(617) 667-2140
(617) 667-0227
Mailing address
330 BROOKLINE AVE, BIDMC - STONEMAN 10, BOSTON, MA 02215-5400
(617) 667-2140
(617) 667-0227
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
47866
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0142379
—
MA
01
—
047866
TUFTS HEALTH PLAN
MA
01
—
E05505
BCBS MA
MA
Enumeration date
11/11/2005
Last updated
07/08/2007
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