Provider Demographics
NPI:1972599975
Name:KERSH, GREGORY D (DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:D
Last Name:KERSH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9748 GROFFS MILL DR
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-6341
Mailing Address - Country:US
Mailing Address - Phone:410-998-3111
Mailing Address - Fax:410-998-3113
Practice Address - Street 1:9748 GROFFS MILL DR
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-6341
Practice Address - Country:US
Practice Address - Phone:410-998-3111
Practice Address - Fax:410-998-3113
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-25
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01706111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2-97921OtherMAMSI HEALTH PLAN ID
MD43448OtherNYL CARE ID
MD521996755003OtherCIGNA PROVIDER ID
MDE301 0001OtherFEDERAL BCBS ID
MD659946OtherAENTA PROVIDER ID
MDE301 0001OtherBLUE CHOICE ID
MDM453OtherCAREFIRST BCBS ID
MDE301 0001OtherBLUE CHOICE ID
MDU72064Medicare UPIN