Individual
DR. GERTRUDE W MANCHESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF PRIMARY CARE, WORCESTER, MA 01655-0002
(508) 856-4227
Mailing address
PO BOX 415348, BOSTON, MA 02241
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
56590
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3011062
—
MA
Enumeration date
11/27/2005
Last updated
04/13/2009
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