Healthcare Provider Details

I. General information

NPI: 1245678614
Provider Name (Legal Business Name): PETER CHARLES GERST D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 N CENTER ST STE 201
HICKORY NC
28601-5036
US

IV. Provider business mailing address

2100 STANTONSBURG RD
GREENVILLE NC
27834-2818
US

V. Phone/Fax

Practice location:
  • Phone: 828-327-8105
  • Fax: 828-327-4245
Mailing address:
  • Phone: 252-744-3229
  • Fax: 252-744-3924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2017-01612
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: