MEDICARE: DR. GEROULD J GIDDINGS DC

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	111N00000X	Chiropractor	38MC00188800	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0082657000	OTHER	NJ	AMERIHEALTH HMO
2	0082657000	OTHER	PA	AMERIHEALTH HMO
3	2203299	OTHER	NJ	SIGNA
4	P3128809	OTHER	NJ	OXFORD

General Provider Information

NPI Number	:	1750374765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEROULD J GIDDINGS DC

Provider Business Mailing Address
First Line	:	8511 MAPLE AVE
Second Line	:
City	:	PENNSAUKEN
State	:	NJ
Zip	:	08109-3337
Country	:	US
Telephone Number	:	856-486-7878
Fax Number	:	856-486-7832

Provider Business Practice Location Address
First Line	:	8511 MAPLE AVE
Second Line	:
City	:	PENNSAUKEN
State	:	NJ
Zip	:	08109-3337
Country	:	US
Telephone Number	:	856-486-7878
Fax Number	:	856-486-7832

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

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	07/08/2007

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