Provider Demographics
NPI:1851528335
Name:GERHARDT, ERICH PAUL (DO)
Entity type:Individual
Prefix:DR
First Name:ERICH
Middle Name:PAUL
Last Name:GERHARDT
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 COVINA CT
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3657
Mailing Address - Country:US
Mailing Address - Phone:773-412-3916
Mailing Address - Fax:
Practice Address - Street 1:555 E CHEVES ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2617
Practice Address - Country:US
Practice Address - Phone:843-777-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036167719208600000X, 2086S0102X, 2086S0127X
SC911042086S0102X
NC2025-006622086S0102X
DC2100126232086S0102X
PAOS0162642086S0102X
MO20230150142086S0102X
IL036.1677192086S0102X
TXQ96162086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX372384301Medicaid
TXP01844334OtherRAIL ROAD MEDICARE