Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | MD038356E | PA |
N | 207RI0011X | Interventional Cardiology | MD038356E | PA |
NPI | 1073552147 |
---|---|
Provider Name | Dr. Elliot Mark Gerber |
First Address | Philadelphia, PA 19107-1500 |
Second Address | Paoli, PA 19301-1763 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 22/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001121691 | (05) | PA |
444043GT6 | MEDICARE ID (01) | PA |