Provider Demographics
NPI:1457473654
Name:GAMARRA, FERNANDO NICOLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:NICOLAS
Last Name:GAMARRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:37399 GARFIELD RD STE 104
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-3672
Mailing Address - Country:US
Mailing Address - Phone:586-286-5400
Mailing Address - Fax:586-576-6263
Practice Address - Street 1:37399 GARFIELD RD STE 104
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48036-3672
Practice Address - Country:US
Practice Address - Phone:586-286-5400
Practice Address - Fax:586-576-6263
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301088745207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology