Provider Demographics
NPI:1821276676
Name:GERJOI, MARCELO N (PA-C)
Entity Type:Individual
Prefix:
First Name:MARCELO
Middle Name:N
Last Name:GERJOI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:MARCELO
Other - Middle Name:N
Other - Last Name:GERJOI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 40480
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36640-0480
Mailing Address - Country:US
Mailing Address - Phone:251-434-3626
Mailing Address - Fax:251-445-2464
Practice Address - Street 1:1601 CENTER ST STE 2D
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1541
Practice Address - Country:US
Practice Address - Phone:251-660-5108
Practice Address - Fax:251-660-5792
Is Sole Proprietor?:No
Enumeration Date:2008-02-04
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA.1436363A00000X
FLPA9110938363A00000X
390200000X
GACHIR0080310111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALA13161AOtherMEDICARE PIN CHIROPRACTICE CARE (DC)