Provider Demographics
NPI:1265470140
Name:BERTIGER, GERALD (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:
Last Name:BERTIGER
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 1:75 HOSPITAL DR
Mailing Address - Street 2:SUITE. 310
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2857
Mailing Address - Country:US
Mailing Address - Phone:740-594-6100
Mailing Address - Fax:740-594-6903
Practice Address - Street 1:4150 BARRETT BLVD
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-8979
Practice Address - Country:US
Practice Address - Phone:717-738-5648
Practice Address - Fax:717-327-4014
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101032217207R00000X, 207RG0100X, 207R00000X
WV29713207RG0100X
SC84527207RG0100X
IN01082717A207RG0100X
PAMD027161E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100008030OtherRAILROAD
SC845278Medicaid
10923096OtherCAQH
PA1009691Medicaid