Provider Demographics
NPI:1376563411
Name:GAETJENS, ROBERT EDWARD (MD,MPH)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EDWARD
Last Name:GAETJENS
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 282
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03825-0282
Mailing Address - Country:US
Mailing Address - Phone:207-676-4100
Mailing Address - Fax:
Practice Address - Street 1:113 WELLS ST.
Practice Address - Street 2:PRATT &WHITNEY AIRCRAFT
Practice Address - City:NORTH BERWICK
Practice Address - State:ME
Practice Address - Zip Code:03906
Practice Address - Country:US
Practice Address - Phone:207-676-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME100072083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine