Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gvantsa Didebulidze, MD

Individual provider Internal Medicine Physician · NPI 1730474644

Gvantsa Didebulidze, MD is an Internal Medicine in Brockton, Massachusetts. Qualified in 2009, 17 years ago. Practices with Select Rehabilitation, LLC, a 2,028-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Massachusetts.

Years since qualifying
17
Licensed in
MA
In the registry since
2011
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

63 Main St
Brockton, MA 02301-4042
Phone: (508) 559-6699
Fax: (508) 559-5073
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 67 South Bedford Street, Burlington, MA 01805-4042 — (781) 744-8000

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 257775 (MA)

Record details

NPI number1730474644
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 20, 2011
Last updated in NPPESMay 19, 2025
Certification dateMay 19, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Also practisesHOSPITALIST
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Select Rehabilitation, Llc — 2028 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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