Provider Demographics
NPI:1033280334
Name:GEHRIS, CLARENCE WINFRED JR (MD)
Entity Type:Individual
Prefix:DR
First Name:CLARENCE
Middle Name:WINFRED
Last Name:GEHRIS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:520 UPPER CHESAPEAKE DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4339
Mailing Address - Country:US
Mailing Address - Phone:410-879-9100
Mailing Address - Fax:410-879-0227
Practice Address - Street 1:520 UPPER CHESAPEAKE DR
Practice Address - Street 2:SUITE 206
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4339
Practice Address - Country:US
Practice Address - Phone:410-879-9100
Practice Address - Fax:410-879-0227
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2015-03-25
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Provider Licenses
StateLicense IDTaxonomies
MDD0001704207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD465958OtherAETNA HMO
MD93903OtherMAMSI
MD103439OtherKAISER
MD1426OtherHELIX
MD200721500Medicaid
MD32051011OtherCAREFIRST
MD4069473OtherAETNA PPO
MD498835OtherNCAS
DCE5130001OtherCAREFIRST BLUECHOICE
MD040011828OtherRAILROAD MEDICARE
MD16260OtherEHP
MD040011828OtherRAILROAD MEDICARE
MD4069473OtherAETNA PPO