Provider Demographics
NPI:1336228022
Name:GERBER, GREGORY JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:JOSEPH
Last Name:GERBER
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 80690
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-0690
Mailing Address - Country:US
Mailing Address - Phone:330-479-5428
Mailing Address - Fax:330-479-5440
Practice Address - Street 1:2819 HAYES AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-5391
Practice Address - Country:US
Practice Address - Phone:419-609-9107
Practice Address - Fax:419-609-9109
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350759212081P2900X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
F76761Medicare UPIN
OH2795542Medicaid
OH4214311Medicare PIN