Provider Demographics
NPI:1013269091
Name:GELBER, JEREMY WINTHROP (MD)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:WINTHROP
Last Name:GELBER
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 1:330 AUBREY RD
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-1817
Mailing Address - Country:US
Mailing Address - Phone:610-642-3999
Mailing Address - Fax:
Practice Address - Street 1:330 AUBREY RD
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-1817
Practice Address - Country:US
Practice Address - Phone:610-642-3999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD427211207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine