Individual
DR. STEPHEN ANDREW GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 MOUNT AUBURN ST STE 310, CAMBRIDGE, MA 02138-5665
(617) 497-1560
(617) 497-1190
Mailing address
300 MOUNT AUBURN ST STE 310, CAMBRIDGE, MA 02138-5665
(617) 497-1560
(617) 497-1190
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD15347
RI
207RC0000X
Cardiovascular Disease Physician
Primary
274883
MA
207RC0000X
Cardiovascular Disease Physician
MD15347
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110146553A
—
MA
Enumeration date
03/31/2012
Last updated
05/18/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us