Provider Demographics
NPI:1881677268
Name:GERSHWIN, MERRILL E
Entity Type:Individual
Prefix:DR
First Name:MERRILL
Middle Name:E
Last Name:GERSHWIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 E. HEALTH SCIENCES DRIVE
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616
Mailing Address - Country:US
Mailing Address - Phone:530-752-2884
Mailing Address - Fax:530-752-4669
Practice Address - Street 1:451 E. HEALTH SCIENCES DRIVE
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616
Practice Address - Country:US
Practice Address - Phone:530-752-2884
Practice Address - Fax:530-752-4669
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG028104207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology