Provider Demographics
NPI:1295901957
Name:GERSTBERGER, MATTHEW R (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:R
Last Name:GERSTBERGER
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 1:101 W 7TH ST
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:PENNSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18073-1512
Mailing Address - Country:US
Mailing Address - Phone:215-679-9321
Mailing Address - Fax:215-679-2386
Practice Address - Street 1:101 W 7TH ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:PENNSBURG
Practice Address - State:PA
Practice Address - Zip Code:18073-1512
Practice Address - Country:US
Practice Address - Phone:215-679-9321
Practice Address - Fax:215-679-2386
Is Sole Proprietor?:No
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD433320207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine