Provider Demographics
NPI:1811974710
Name:GERTLER, PAUL ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ALAN
Last Name:GERTLER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4801 DORSEY HALL DR
Mailing Address - Street 2:SUITE 226
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7766
Mailing Address - Country:US
Mailing Address - Phone:410-992-7440
Mailing Address - Fax:443-276-0349
Practice Address - Street 1:4801 DORSEY HALL DR
Practice Address - Street 2:STE 226
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7766
Practice Address - Country:US
Practice Address - Phone:410-992-7440
Practice Address - Fax:443-276-0349
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2017-01-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD22448207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD153891800Medicaid
MD153891800Medicaid
MDC49211Medicare UPIN