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General NPI Number Information
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NPI Number | 1154751345
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Entity Type | Organization
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Legal Business Name | GERRISH GASTROENTEROLOGY, PL
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Dates
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Enumeration Date | 11/25/2013
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Last Update Date | 12/04/2013
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Provider Practice Location Address
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Address Line | 2102 S MACDILL AVE SUITE D
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City | TAMPA
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State | FL
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Zip | 33629-5934
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Country | US
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Telephone | 813-304-2140
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Fax |
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Provider Business Mailing Address
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Address Line | 2102 S MACDILL AVE SUITE D
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City | TAMPA
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State | FL
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Zip | 33629-5934
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Country | US
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Telephone | 813-304-2140
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEPHEN T GERRISH
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Credential | M.D.
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Telephone | 813-304-2140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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