Provider Demographics
NPI:1528038288
Name:GERBER, MATTHEW J (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:J
Last Name:GERBER
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:PO BOX 18946
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27619-8946
Mailing Address - Country:US
Mailing Address - Phone:919-787-7171
Mailing Address - Fax:919-420-2028
Practice Address - Street 1:3010 ANDERSON DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7796
Practice Address - Country:US
Practice Address - Phone:919-787-7171
Practice Address - Fax:919-420-2028
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200200224207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC132H3OtherBCBS NC
NC89132H3Medicaid
NC89132H3Medicaid
NC132H3OtherBCBS NC