Provider Demographics
NPI:1790810521
Name:GERWITZ, JANICE MARIE
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:MARIE
Last Name:GERWITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:MARIE
Other - Last Name:METZLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9512 DORISANN CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-6304
Mailing Address - Country:US
Mailing Address - Phone:314-631-5038
Mailing Address - Fax:314-631-5064
Practice Address - Street 1:9512 DORISANN CT
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-6304
Practice Address - Country:US
Practice Address - Phone:314-631-5038
Practice Address - Fax:314-631-5064
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies