MEDICARE: DR. GERALD M REHERT 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	207VG0400X	Gynecology Physician	016128	GA

General Provider Information

NPI Number	:	1962496513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GERALD M REHERT M.D.

Provider Business Mailing Address
First Line	:	285 BOULEVARD NE
Second Line	:	#520
City	:	ATLANTA
State	:	GA
Zip	:	30312-4205
Country	:	US
Telephone Number	:	404-688-2800
Fax Number	:

Provider Business Practice Location Address
First Line	:	285 BOULEVARD NE
Second Line	:	#520
City	:	ATLANTA
State	:	GA
Zip	:	30312-4205
Country	:	US
Telephone Number	:	404-688-2800
Fax Number	:

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

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	07/08/2007

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