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General NPI Number Information
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NPI Number | 1083668792
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Entity Type | Individual
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Provider Name | GERRY L SHOMER DO
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 12/09/2019
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Provider Practice Location Address
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Address Line | 209 WESTMINSTER PL
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City | AMBLER
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State | PA
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Zip | 19002-2883
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Country | US
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Telephone | 215-264-0845
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Fax | 215-233-1015
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Provider Business Mailing Address
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Address Line | 209 WESTMINSTER PL
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City | AMBLER
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State | PA
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Zip | 19002-2883
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Country | US
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Telephone | 215-643-0944
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS003048L
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License Number State | PA
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