Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 28390 | MS |
NPI | 1487231874 |
---|---|
Provider Name | Kerstin Gerhold |
First Address | Madison, MS 39110-6115 |
Second Address | Madison, MS 39110-9299 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2021 |
Last Update Date | 24/03/2021 |