Provider Demographics
NPI:1073887519
Name:GERARD HERSHEWE D O LTD
Entity Type:Organization
Organization Name:GERARD HERSHEWE D O LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:HERSHEWE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:775-329-4500
Mailing Address - Street 1:1500 E 2ND ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1262
Mailing Address - Country:US
Mailing Address - Phone:775-329-4500
Mailing Address - Fax:775-329-4595
Practice Address - Street 1:1500 E 2ND ST
Practice Address - Street 2:SUITE 203
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1262
Practice Address - Country:US
Practice Address - Phone:775-329-4500
Practice Address - Fax:775-329-4595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV5142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002016420Medicaid
NVC94028Medicare UPIN
NVVDO514BMedicare PIN