Provider Demographics
NPI:1104863067
Name:GEJER, ERIC R (DO)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:R
Last Name:GEJER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 829641
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-9641
Mailing Address - Country:US
Mailing Address - Phone:267-370-5296
Mailing Address - Fax:152-303-7252
Practice Address - Street 1:599 W STATE ST STE 200
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2567
Practice Address - Country:US
Practice Address - Phone:267-893-6800
Practice Address - Fax:267-893-6820
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0S010641L207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1876343OtherHIGHMARK BLUE SHIELD
PA1876343OtherHIGHMARK BLUE SHIELD
PA103521Medicare PIN
PA1876343OtherHIGHMARK BLUE SHIELD
PA095927Medicare PIN