Provider Demographics
NPI:1609094473
Name:GERLACH, KATHERINE J (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:J
Last Name:GERLACH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3922 WOODLEY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1130
Mailing Address - Country:US
Mailing Address - Phone:419-291-2121
Mailing Address - Fax:419-479-6017
Practice Address - Street 1:3922 WOODLEY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1130
Practice Address - Country:US
Practice Address - Phone:419-291-2121
Practice Address - Fax:419-479-6017
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.089023208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000538191OtherANTHEM
OH7574901OtherAETNA
OH06791OtherPARAMOUNT
OH2751071Medicaid
OH7475901OtherPPOM
MI47131OtherHEALTH PLAN OF MICHIGAN
OH06791OtherPARAMOUNT
OH000000538191OtherANTHEM
OH7475901OtherPPOM
OH7574901OtherAETNA