Provider Demographics
NPI:1750623278
Name:GERN, BENJAMIN HENRY (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:HENRY
Last Name:GERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 SANDPOINT WAY NE, M/S M.A.7.226
Mailing Address - Street 2:SEATTLE CHILDREN'S HOSPITAL
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115
Mailing Address - Country:US
Mailing Address - Phone:206-987-2000
Mailing Address - Fax:
Practice Address - Street 1:4800 SANDPOINT WAY NE, M/S M.A.7.226
Practice Address - Street 2:SEATTLE CHILDREN'S HOSPITAL
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115
Practice Address - Country:US
Practice Address - Phone:206-987-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-22
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA606490292080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases