Provider Demographics
NPI:1063724052
Name:GERBLICH MD INC
Entity type:Organization
Organization Name:GERBLICH MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADI
Authorized Official - Middle Name:A
Authorized Official - Last Name:GERBLICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-464-0778
Mailing Address - Street 1:247755 CHAGRIN BLVD
Mailing Address - Street 2:320
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-464-0778
Mailing Address - Fax:216-765-1461
Practice Address - Street 1:24755 CHAGRIN BLVD
Practice Address - Street 2:320
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5682
Practice Address - Country:US
Practice Address - Phone:216-464-0778
Practice Address - Fax:216-464-0856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A83125Medicare UPIN