Gersman, Mark Andrew

Gersman, Mark Andrew is an individual health care provider with primary practice located at 4676 Douglas Cir Nw , Canton OH 44718-3619. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Retina Specialist, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Gersman, Mark Andrew can be contacted via phone (330) 494-1116.

Contact Information

Primary practice address
4676 Douglas Cir Nw Canton OH 44718-3619
Fax: (330) 494-0276
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 35.060285 Ohio
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 35060285 Ohio
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 18631 West Virginia
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X MD057570L Pennsylvania
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X MD057570L Pennsylvania

Profile Details

NPI number 1205839552
LBN Legal business name Gersman, Mark Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated May 24th, 2021 - about 3 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205839552 NPPES
Ohio Other 4036611 MCR # OTHER TAX ID
Ohio MEDICAID 0096237000 MCR # OTHER TAX ID
Ohio Other 180041827 MCR # OTHER TAX ID
Ohio MEDICAID 0015118570004 MCR # OTHER TAX ID
Ohio MEDICAID 0975753 MCR # OTHER TAX ID

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