MEDICARE: ERIC A GERSHMAN M D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RX0202X	Medical Oncology Physician	17168	NV
2	207RX0202X	Medical Oncology Physician	ME55276	FL
3	207RH0000X	Hematology (Internal Medicine) Physician	ME55276	FL
4	207RH0000X	Hematology (Internal Medicine) Physician	MD202391	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316903768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC A GERSHMAN M D

Provider Business Mailing Address
First Line	:	PO BOX 102222
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30368-2222
Country	:	US
Telephone Number	:	239-274-8200
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 MEMORIAL MEDICAL PKWY STE 200
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-5979
Country	:	US
Telephone Number	:	386-586-1860
Fax Number	:	386-586-1861

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	01/30/2026

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Directions to “ ERIC A GERSHMAN M D” Practice Location

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