Basic Information
| Provider Information | |||||||||
| NPI: | 1821376799 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAZER | ||||||||
| FirstName: | BENNY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 W READ ST | ||||||||
| Address2: | SUITE 304 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212014912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4437997104 | ||||||||
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| Practice Location | |||||||||
| Address1: | 655 N WOLFE ST | ||||||||
| Address2: | BLALOCK 655 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212870001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109556796 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2011 | ||||||||
| LastUpdateDate: | 07/26/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 36584 | ZZ | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.