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General NPI Number Information
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NPI Number | 1609002492
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Entity Type | Individual
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Provider Name | PAUL GERRARD M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2009
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 166 PLEASANT ST
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City | YARMOUTH
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State | ME
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Zip | 04096-6111
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Country | US
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Telephone | 803-292-8602
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Fax |
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Provider Business Mailing Address
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Address Line | 166 PLEASANT ST
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City | YARMOUTH
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State | ME
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Zip | 04096-6111
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Country | US
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Telephone | 803-292-8602
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 253357
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License Number State | MA
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