Individual
DR. STEPHEN E GELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6117
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6117
Taxonomy
Speciality
Code
Description
License number
State
207NP0225X
Pediatric Dermatology Physician
Primary
41583
MA
208000000X
Pediatrics Physician
41583
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2072020
—
MA
Enumeration date
09/20/2006
Last updated
08/15/2007
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