Healthcare Provider Details

I. General information

NPI: 1881672608
Provider Name (Legal Business Name): GERALD T BIHN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1103 VILLAGE SQUARE DR SUITE 205
PERRYSBURG OH
43551-1783
US

IV. Provider business mailing address

27459 W RIVER RD
PERRYSBURG OH
43551-1028
US

V. Phone/Fax

Practice location:
  • Phone: 419-874-4840
  • Fax: 419-874-0665
Mailing address:
  • Phone: 419-874-8811
  • Fax: 419-874-0665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number35059322
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: