Provider Demographics
NPI:1285733048
Name:GERA, THOMAS EDWARD (PA)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:EDWARD
Last Name:GERA
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 SETON DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1950
Mailing Address - Country:US
Mailing Address - Phone:301-724-6787
Mailing Address - Fax:301-724-0701
Practice Address - Street 1:14601 BURBRIDGE RD SE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-8724
Practice Address - Country:US
Practice Address - Phone:301-784-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0003040363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDQ53475Medicare UPIN
MDKM94M563Medicare ID - Type Unspecified