Dr ELLIS B GARDNER is a male medical professional, specializing in Pediatric Medicine. He graduated in 1996 from Dartmouth Medical School.
MASCOMA COMMUNITY HEALTHCARE INC
18 ROBERTS RD
CANAAN
NH
037417644
Tel: 6035234343
| Npi | 1932130630 |
| Pac Id | 2163706227 |
| Professional Enrollment Id | I20170309000863 |
| Last Name | GARDNER |
| First Name | ELLIS |
| Middle Name | B |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | DARTMOUTH MEDICAL SCHOOL |
| Graduation Year | 1996 |
| Primary Specialty | PEDIATRIC MEDICINE |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
| Secondary Specialty 3 | |
| Secondary Specialty 4 | |
| All Secondary Specialties | |
| Organization Legal Name | MASCOMA COMMUNITY HEALTHCARE INC |
| Group Practice Pac Id | 2466736525 |
| Number Of Group Practice Members | 5 |
| Line 1 Street Address | 18 ROBERTS RD |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | CANAAN |
| State | NH |
| Zip Code | 037417644 |
| Phone Number | 6035234343 |
| Hospital Affiliation Ccn 1 | 300003 |
| Hospital Affiliation Lbn 1 | MARY HITCHCOCK MEMORIAL HOSPITAL |
| Hospital Affiliation Ccn 2 | 301305 |
| Hospital Affiliation Lbn 2 | ALICE PECK DAY MEMORIAL HOSPITAL |
| Hospital Affiliation Ccn 3 | |
| Hospital Affiliation Lbn 3 | |
| Hospital Affiliation Ccn 4 | |
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| Hospital Affiliation Ccn 5 | |
| Hospital Affiliation Lbn 5 | |
| Professional Accepts Medicare Assignment | Y |
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