Provider Demographics
NPI:1659399103
Name:GERA, JAMIE ANNE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:ANNE
Last Name:GERA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:JAMIE
Other - Middle Name:ANNE
Other - Last Name:SIUDYLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:12252 WILLIAMS RD SE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-7960
Mailing Address - Country:US
Mailing Address - Phone:240-362-7333
Mailing Address - Fax:240-362-7391
Practice Address - Street 1:12252 WILLIAMS RD SE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-7960
Practice Address - Country:US
Practice Address - Phone:240-362-7333
Practice Address - Fax:240-362-7391
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0003021363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD886MO447Medicare PIN
MDQ71854Medicare UPIN
MDDC5469Medicare PIN