Provider Demographics
NPI:1922008457
Name:GERAD, HENRY (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:GERAD
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:PO BOX 636930
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:513-981-5015
Mailing Address - Fax:
Practice Address - Street 1:803 W MARKET ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-2796
Practice Address - Country:US
Practice Address - Phone:419-222-3737
Practice Address - Fax:419-229-3234
Is Sole Proprietor?:No
Enumeration Date:2005-07-27
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH51802207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000213805OtherANTHEM
OH900004050OtherRAILROAD MEDICARE
OH0588690Medicaid
OH000000213805OtherANTHEM
OH0588690Medicaid