Provider Demographics
NPI:1124478755
Name:GAERTNER, ERICA (MD)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:
Last Name:GAERTNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10084 REISTERSTOWN RD STE 300A
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4160
Mailing Address - Country:US
Mailing Address - Phone:410-601-7529
Mailing Address - Fax:
Practice Address - Street 1:10084 REISTERSTOWN RD STE 300A
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4160
Practice Address - Country:US
Practice Address - Phone:410-601-7529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT211992207R00000X, 2080S0010X
MDD0089481207R00000X, 207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports Medicine