Organization
GULFSHORE MEDICAL CONSULTANTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY M RODBERG MD (PRESIDENT)
(228) 872-1951
Entity
Organization
Contact information
Practice address
22A DOCTORS DR, OCEAN SPRINGS, MS 39564-5721
(228) 872-1951
(228) 875-9998
Mailing address
22A DOCTORS DR, OCEAN SPRINGS, MS 39564-5721
(228) 872-1951
(228) 875-9998
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
14252
MS
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
17943
MS
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
18516
MS
207RP1001X
Pulmonary Disease Physician
14252
MS
207RP1001X
Pulmonary Disease Physician
17943
MS
207RP1001X
Pulmonary Disease Physician
18516
MS
207RR0500X
Rheumatology Physician
15014
MS
207RS0012X
Sleep Medicine (Internal Medicine) Physician
14252
MS
207RS0012X
Sleep Medicine (Internal Medicine) Physician
17943
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114969
—
MS
05
—
00117171
—
MS
05
—
00126926
—
MS
05
—
07521804
—
MS
05
—
09015817
—
MS
Enumeration date
12/14/2006
Last updated
01/22/2008
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