Provider Demographics
NPI:1639105513
Name:MARSHALL, GAD A (MD)
Entity type:Individual
Prefix:
First Name:GAD
Middle Name:A
Last Name:MARSHALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GAD
Other - Middle Name:ASHER
Other - Last Name:BEN-DROR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:BWH MEMORY DISORDER UNIT
Mailing Address - Street 2:221 LONGWOOD AVE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-732-8085
Mailing Address - Fax:617-738-9122
Practice Address - Street 1:BWH MEMORY DISORDER UNIT
Practice Address - Street 2:221 LONGWOOD AVE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-732-8085
Practice Address - Fax:617-738-9122
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA857282084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology