Provider Demographics
NPI:1336142207
Name:GERBER, MICHAEL (DPM)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:GERBER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6521 FRANK AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-7265
Mailing Address - Country:US
Mailing Address - Phone:330-244-9688
Mailing Address - Fax:330-244-1966
Practice Address - Street 1:2400 WALES AVE NW STE C
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-2366
Practice Address - Country:US
Practice Address - Phone:330-880-0088
Practice Address - Fax:330-880-0089
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH36002652213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist