Provider Demographics
NPI:1568401065
Name:GEHRMAN, PHILIP R (PHD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:R
Last Name:GEHRMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 MARKET ST
Mailing Address - Street 2:SUITE 670
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3309
Mailing Address - Country:US
Mailing Address - Phone:215-746-3578
Mailing Address - Fax:
Practice Address - Street 1:3535 MARKET ST
Practice Address - Street 2:SUITE 670
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3309
Practice Address - Country:US
Practice Address - Phone:215-746-3578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015793103T00000X, 2084S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0010XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySports Medicine
No103T00000XBehavioral Health & Social Service ProvidersPsychologist