MEDICARE: DR. ROBERT L. GERTZ O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	TA1970	MD

General Provider Information

NPI Number	:	1023158193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT L. GERTZ O.D.

Provider Business Mailing Address
First Line	:	3540 SUGARLOAF PKWY
Second Line	:	D-04
City	:	URBANA
State	:	MD
Zip	:	21704-7912
Country	:	US
Telephone Number	:	301-874-5777
Fax Number	:	301-874-0497

Provider Business Practice Location Address
First Line	:	3540 SUGARLOAF PKWY
Second Line	:	D-04
City	:	URBANA
State	:	MD
Zip	:	21704-7912
Country	:	US
Telephone Number	:	301-874-5777
Fax Number	:	301-874-0497

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	07/13/2010

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