Healthcare Provider Details

I. General information

NPI: 1871587022
Provider Name (Legal Business Name): ROBERT GERDING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 E ROYALTON RD SUITE 202
CLEVELAND OH
44147-2522
US

IV. Provider business mailing address

303 E ROYALTON RD SUITE 202
CLEVELAND OH
44147-2522
US

V. Phone/Fax

Practice location:
  • Phone: 440-717-2023
  • Fax:
Mailing address:
  • Phone: 440-717-2023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number35048973
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: