Provider Demographics
NPI:1114913456
Name:GERBER, LOWELL IAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LOWELL
Middle Name:IAN
Last Name:GERBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17 BETTYS LN
Mailing Address - Street 2:
Mailing Address - City:HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02645-2517
Mailing Address - Country:US
Mailing Address - Phone:207-497-2996
Mailing Address - Fax:877-203-8719
Practice Address - Street 1:100 SPENCER'S RIDGE RD.
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:ME
Practice Address - Zip Code:04032-7138
Practice Address - Country:US
Practice Address - Phone:207-869-9010
Practice Address - Fax:207-869-9013
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME017412207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1114913456OtherBCBS
D43135Medicare UPIN