Provider Demographics
NPI:1154399665
Name:PERZ, GERHARD LOUIS (MD)
Entity type:Individual
Prefix:
First Name:GERHARD
Middle Name:LOUIS
Last Name:PERZ
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 1:18101 LORAIN AVENUE CLEVELAND CLINIC-FAIRVIEW HOSPITAL
Mailing Address - Street 2:EMERGENCY SERVICES
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-5612
Mailing Address - Country:US
Mailing Address - Phone:216-476-7312
Mailing Address - Fax:
Practice Address - Street 1:18101 LORAIN AVENUE CLEVELAND CLINIC-FAIRVIEW HOSPITAL
Practice Address - Street 2:EMERGENCY SERVICES
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-5612
Practice Address - Country:US
Practice Address - Phone:216-476-7312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35064661146D00000X
OH35-0646612080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0968154Medicaid
OHPE0792454Medicare PIN