Provider Demographics
NPI:1669442737
Name:GERBER, SAMUEL D (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:D
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 1:14 RESEARCH PL
Mailing Address - Street 2:
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-2412
Mailing Address - Country:US
Mailing Address - Phone:978-454-0706
Mailing Address - Fax:978-259-4695
Practice Address - Street 1:14 RESEARCH PL
Practice Address - Street 2:
Practice Address - City:NORTH CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-2412
Practice Address - Country:US
Practice Address - Phone:978-454-0706
Practice Address - Fax:978-259-4695
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA48889207X00000X
NH7567207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30009524Medicaid
MA6197116Medicaid
NHRE7415Medicare ID - Type Unspecified
NH30009524Medicaid
MAJ04690Medicare ID - Type Unspecified