Individual
DR. RICHARD CHARLES GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
77 MASS AVE, MIT MEDICAL DEPT RM 23 215, CAMBRIDGE, MA 02139-4301
(617) 253-1681
Mailing address
77 MASSACHUSETTS AVE, E23-268, CAMBRIDGE, MA 02139-4301
(617) 253-4988
(617) 253-4988
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
29590
MA
207RG0100X
Gastroenterology Physician
Primary
29590
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0130745
—
MA
Enumeration date
10/25/2005
Last updated
05/09/2012
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