MEDICARE: PHILIP R GEHRMAN PHD

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	103T00000X	Psychologist	PS015793	PA
2	2084S0010X	Sports Medicine (Psychiatry & Neurology) Physician	PS015793	PA

General Provider Information

NPI Number	:	1568401065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP R GEHRMAN PHD

Provider Business Mailing Address
First Line	:	3535 MARKET ST
Second Line	:	SUITE 670
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-3309
Country	:	US
Telephone Number	:	215-746-3578
Fax Number	:

Provider Business Practice Location Address
First Line	:	3535 MARKET ST
Second Line	:	SUITE 670
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-3309
Country	:	US
Telephone Number	:	215-746-3578
Fax Number	:

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	10/21/2014

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