MEDICARE: DR. JEROME BENJAMIN GABRY 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
1	207W00000X	Ophthalmology Physician	D43931	MD

Other Identifiers

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

General Provider Information

NPI Number	:	1356342117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEROME BENJAMIN GABRY MD

Provider Business Mailing Address
First Line	:	2101 MEDICAL PARK DR STE 101
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-4053
Country	:	US
Telephone Number	:	301-681-6600
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 MEDICAL PARK DR STE 101
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20902-4053
Country	:	US
Telephone Number	:	301-681-6600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	11/08/2023

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