MEDICARE: DR. GREGORY JOSEPH GERBER MD

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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	35075921	OH
2	208100000X	Physical Medicine & Rehabilitation Physician	35075921	OH

General Provider Information

NPI Number	:	1336228022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY JOSEPH GERBER MD

Provider Business Mailing Address
First Line	:	PO BOX 80690
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44708-0690
Country	:	US
Telephone Number	:	330-479-5428
Fax Number	:	330-479-5440

Provider Business Practice Location Address
First Line	:	2819 HAYES AVE
Second Line	:	SUITE 7
City	:	SANDUSKY
State	:	OH
Zip	:	44870-5391
Country	:	US
Telephone Number	:	419-609-9107
Fax Number	:	419-609-9109

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

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	06/18/2015

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