Basic Information
| Provider Information | |||||||||
| NPI: | 1386939205 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GREGORY J GERBER, M.D. LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2819 HAYES AVE | ||||||||
| Address2: | SUITE 7 | ||||||||
| City: | SANDUSKY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448705391 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4196099107 | ||||||||
| FaxNumber: | 4196099109 | ||||||||
| Practice Location | |||||||||
| Address1: | 2819 HAYES AVE | ||||||||
| Address2: | SUITE 7 | ||||||||
| City: | SANDUSKY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 448705391 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4196099107 | ||||||||
| FaxNumber: | 4196099109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2011 | ||||||||
| LastUpdateDate: | 06/23/2011 | ||||||||
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| AuthorizedOfficialLastName: | GERBER | ||||||||
| AuthorizedOfficialFirstName: | GREGORY | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4196099107 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2081P2900X | 35-075921 | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine |
No ID Information.