Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 01037332 | IN |
Y | 208600000X | Surgeon | 01037332 | IN |
NPI | 1013901347 |
---|---|
Provider Name | Winston C Gerig |
First Address | Goshen, IN 46526-5232 |
Second Address | Goshen, IN 46526-5232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2005 |
Last Update Date | 04/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100354570 | (05) | IN |
E05314 | (02) |