Provider Demographics
NPI:1619006160
Name:GERLICH, MARY ELIZABETH (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELIZABETH
Last Name:GERLICH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 BEAR CABIN DR
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2732
Mailing Address - Country:US
Mailing Address - Phone:410-420-2829
Mailing Address - Fax:
Practice Address - Street 1:2225 OLD EMMORTON ROAD
Practice Address - Street 2:SUITE 210
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6123
Practice Address - Country:US
Practice Address - Phone:410-515-4900
Practice Address - Fax:410-515-0777
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20527225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD61990001OtherCAREFIRST BCBS