Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | D0001704 | MD |
NPI | 1033280334 |
---|---|
Provider Name | Dr. Clarence Winfred Gehris JR. |
First Address | Bel Air, MD 21014-4339 |
Second Address | Bel Air, MD 21014-4339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2006 |
Last Update Date | 25/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040011828 | RAILROAD MEDICARE (01) | MD |
103439 | KAISER (01) | MD |
1426 | HELIX (01) | MD |
16260 | EHP (01) | MD |
200721500 | (05) | MD |
32051011 | CAREFIRST (01) | MD |
4069473 | AETNA PPO (01) | MD |
465958 | AETNA HMO (01) | MD |
498835 | NCAS (01) | MD |
93903 | MAMSI (01) | MD |
C48949 | (02) | MD |
E5130001 | CAREFIRST BLUECHOICE (01) | DC |