Healthcare Provider Details

I. General information

NPI: 1942313176
Provider Name (Legal Business Name): STEVEN ARNOLD GERSH DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8556 FORT SMALLWOOD ROAD SUITE D
PASADENA MD
21122
US

IV. Provider business mailing address

4660 WILKENS AVE SUITE 202
BALTIMORE MD
21229-4848
US

V. Phone/Fax

Practice location:
  • Phone: 410-255-1190
  • Fax: 410-255-1484
Mailing address:
  • Phone: 410-242-7066
  • Fax: 410-242-4126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number01089
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: