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General NPI Number Information
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NPI Number | 1073519393
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Entity Type | Individual
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Provider Name | JOSEPH GERADTS MD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 600 MOYE BLVD. DEPARTMENT OF PATHOLOGY, ECU HEALTH MEDICAL CENTER
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City | GREENVILLE
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State | NC
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Zip | 27834-2350
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Country | US
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Telephone | 919-943-3371
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Fax |
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Provider Business Mailing Address
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Address Line | 123 THAMES DR
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City | GOOSE CREEK
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State | SC
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Zip | 29445-7185
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Country | US
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Telephone | 919-943-3371
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 265672
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | G65531
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 9300702
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 221876
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 93-00702
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License Number State | NC
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