MEDICARE: ROBERT L.GERDING

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	208200000X	Plastic Surgery Physician		OH

General Provider Information

NPI Number	:	1730173980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT L.GERDING

Provider Business Mailing Address
First Line	:	303 E ROYALTON RD
Second Line	:	SUITE 202
City	:	BROADVIEW HEIGHTS
State	:	OH
Zip	:	44147-2522
Country	:	US
Telephone Number	:	440-717-2023
Fax Number	:	440-717-2023

Provider Business Practice Location Address
First Line	:	303 E ROYALTON RD
Second Line	:	SUITE 202
City	:	BROADVIEW HEIGHTS
State	:	OH
Zip	:	44147-2522
Country	:	US
Telephone Number	:	440-717-2023
Fax Number	:	440-717-2023

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT GERDING
Credential	:	M.D.
Telephone Number	:	440-717-2023

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	07/21/2022

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