Healthcare Provider Details

I. General information

NPI: 1255968202
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL GEBARA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 11/17/2023
Certification Date: 11/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HADDON AVE FL 6
CAMDEN NJ
08103-3101
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-757-3500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number25MA11788900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: