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NPI Code Detail

MEDICARE: MARY C GHERE MD

MEDICARE: MARY C GHERE 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
1208200000XPlastic Surgery PhysicianMD.202966LA
22082S0105XSurgery of the Hand (Plastic Surgery) PhysicianMD.202966LA

General Provider Information

NPI Number : 1063679512
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY C GHERE MD
Provider Business Mailing Address
First Line : 4212 BLUEBONNET BLVD STE A
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-9675
Country : US
Telephone Number : 225-399-0001
Fax Number : 225-399-0008
Provider Business Practice Location Address
First Line : 4212 BLUEBONNET BLVD STE A
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-9675
Country : US
Telephone Number : 225-399-0001
Fax Number : 225-399-0008
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2008
Last Update Date : 01/20/2026

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Directions to “ MARY C GHERE MD” Practice Location

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