Criste, Gerson A
Criste, Gerson A is an individual health care provider with primary practice located at 1390 Hope Dr , Carbondale IL 62901-5306. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Criste, Gerson A can be contacted via phone (618) 351-4972.Contact Information
Primary practice address
1390 Hope Dr
Carbondale IL 62901-5306
Phone: (618) 351-4972
Fax: (618) 351-6522
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 2084P2900X | 036120557 | Illinois |
Profile Details
| NPI number | 1265698260 |
|---|---|
| LBN Legal business name | Criste, Gerson A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 30th, 2008 |
| Last updated | May 21st, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265698260 | NPPES |
| Minnesota | Other | P00785330 | RAILROAD MEDICARE |
| Minnesota | Other | 3932056 | RAILROAD MEDICARE |
| Minnesota | Other | 036120557 | RAILROAD MEDICARE |
| Minnesota | MEDICAID | 036120557 | RAILROAD MEDICARE |
| Minnesota | Other | 721089 | RAILROAD MEDICARE |
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