Provider Demographics
NPI:1265654875
Name:GERSTENBLITH, ADAM THEODORE (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:THEODORE
Last Name:GERSTENBLITH
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 1:246 EASTERN BLVD N
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5965
Mailing Address - Country:US
Mailing Address - Phone:301-671-2400
Mailing Address - Fax:
Practice Address - Street 1:246 EASTERN BLVD N
Practice Address - Street 2:SUITE 102
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740
Practice Address - Country:US
Practice Address - Phone:301-671-2400
Practice Address - Fax:301-671-2403
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21124207R00000X
PAMD442919207WX0107X
MDD0075032207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine