Healthcare Provider Details

I. General information

NPI: 1881635068
Provider Name (Legal Business Name): MICHAEL R GERBER DPM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 WALES AVE NW STE C
MASSILLON OH
44646-2366
US

IV. Provider business mailing address

6521 FRANK RD NW
NORTH CANTON OH
44720
US

V. Phone/Fax

Practice location:
  • Phone: 308-800-0883
  • Fax: 330-880-0089
Mailing address:
  • Phone: 330-244-9688
  • Fax: 330-244-1966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberOH36002652G
License Number StateOH

VIII. Authorized Official

Name: MRS. SARA SHEPHERD
Title or Position: INSURANCE CLAIMS PROCESSOR
Credential:
Phone: 330-479-8705