MEDICARE: DR. GREGORY D KERSH D.C.

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	01706	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2-97921	OTHER	MD	MAMSI HEALTH PLAN ID
2	43448	OTHER	MD	NYL CARE ID
3	521996755003	OTHER	MD	CIGNA PROVIDER ID
4	E301 0001	OTHER	MD	FEDERAL BCBS ID
5	659946	OTHER	MD	AENTA PROVIDER ID
6	E301 0001	OTHER	MD	BLUE CHOICE ID
7	M453	OTHER	MD	CAREFIRST BCBS ID

General Provider Information

NPI Number	:	1972599975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY D KERSH D.C.

Provider Business Mailing Address
First Line	:	9748 GROFFS MILL DR
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-6341
Country	:	US
Telephone Number	:	410-998-3111
Fax Number	:	410-998-3113

Provider Business Practice Location Address
First Line	:	9748 GROFFS MILL DR
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-6341
Country	:	US
Telephone Number	:	410-998-3111
Fax Number	:	410-998-3113

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

Provider Enumeration Date	:	09/25/2005
Last Update Date	:	08/15/2012

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Directions to “ DR. GREGORY D KERSH D.C.” Practice Location

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