Provider Demographics
NPI:1801603618
Name:GERBER, GREGORY FRANCIS JR
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:FRANCIS
Last Name:GERBER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1488 EDEN DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-4451
Mailing Address - Country:US
Mailing Address - Phone:301-525-8955
Mailing Address - Fax:
Practice Address - Street 1:20500 SENECA MEADOWS PKWY STE 101
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-7009
Practice Address - Country:US
Practice Address - Phone:240-771-4843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MD390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program