MEDICARE: DR. KEVIN B GEROLD DO

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	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	H31298	MD
2	207L00000X	Anesthesiology Physician	H31298	MD
3	207P00000X	Emergency Medicine Physician	H31298	MD

General Provider Information

NPI Number	:	1326041518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN B GEROLD DO

Provider Business Mailing Address
First Line	:	1212 HART RD
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21286-1632
Country	:	US
Telephone Number	:	410-583-9848
Fax Number	:	410-583-9875

Provider Business Practice Location Address
First Line	:	4940 EASTERN AVENUE
Second Line	:	A3W-387 DEPARTMENT OF ANESTHESIOLOGY, JHBMC
City	:	BALTIMORE
State	:	MD
Zip	:	21224-2780
Country	:	US
Telephone Number	:	410-550-4557
Fax Number	:	410-550-0443

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	01/14/2013

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