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NPI Code Detail

MEDICARE: DR. ELIOT MARC GELWAN MD

MEDICARE: DR. ELIOT MARC GELWAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician53266MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700952702
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELIOT MARC GELWAN MD
Provider Business Mailing Address
First Line : 82 PERRY ST
Second Line :
City : BROOKLINE
State : MA
Zip : 02446-6907
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 115 MILL ST # AB335
Second Line :
City : BELMONT
State : MA
Zip : 02478-1048
Country : US
Telephone Number : 617-855-3872
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2006
Last Update Date : 10/18/2022

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