Provider Demographics
NPI:1740235092
Name:ADLER, GERALD PAIGE (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:PAIGE
Last Name:ADLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 TREE LANE ST 450
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078
Mailing Address - Country:US
Mailing Address - Phone:770-979-9005
Mailing Address - Fax:770-985-4733
Practice Address - Street 1:1700 TREE LANE ST 450
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078
Practice Address - Country:US
Practice Address - Phone:770-979-9005
Practice Address - Fax:770-985-4733
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA023558207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00251633AMedicaid
GAD44682Medicare UPIN
GA$$$$$$$$$AMedicare PIN