Provider Demographics
NPI:1164422861
Name:GEGWICH, FRANK (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:
Last Name:GEGWICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 E 16TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BERWICK
Mailing Address - State:PA
Mailing Address - Zip Code:18603-2321
Mailing Address - Country:US
Mailing Address - Phone:570-752-5056
Mailing Address - Fax:570-752-0841
Practice Address - Street 1:751 E 16TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:BERWICK
Practice Address - State:PA
Practice Address - Zip Code:18603-2321
Practice Address - Country:US
Practice Address - Phone:570-752-5056
Practice Address - Fax:570-752-0841
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD017655E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000632301/0004Medicaid
PA0998135OtherKEYSTONE HEALTH PLAN CENT
PA998135OtherHEALTH ONE
PA102372OtherHIGHMARK
PA95628OtherHEALTH AMERICA/HEALTH ASS
PA002649OtherFIRST PRIORITY HEALTH
PAP003229OtherGATEWAY HEALTH PLAN
PA11958OtherGEISINGER HEALTH PLAN
PA998135OtherHEALTH ONE
PA11958OtherGEISINGER HEALTH PLAN