Healthcare Provider Details

I. General information

NPI: 1174990451
Provider Name (Legal Business Name): ALEXIS GERBER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2015
Last Update Date: 12/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S 11TH ST
PHILADELPHIA PA
19107
US

IV. Provider business mailing address

111 S 11TH ST
PHILADELPHIA PA
19107-4824
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-8900
  • Fax: 215-923-3447
Mailing address:
  • Phone: 215-955-8900
  • Fax: 215-923-3447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD464725
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: