Provider Demographics
NPI:1487712741
Name:GERHARD, ROBERT THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:THOMAS
Last Name:GERHARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:HANSON
Mailing Address - State:MA
Mailing Address - Zip Code:02341-1166
Mailing Address - Country:US
Mailing Address - Phone:781-294-4577
Mailing Address - Fax:781-294-4164
Practice Address - Street 1:381 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:HANSON
Practice Address - State:MA
Practice Address - Zip Code:02341-1166
Practice Address - Country:US
Practice Address - Phone:781-294-4577
Practice Address - Fax:781-294-4164
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA851111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA35051OtherHARVARD-PILGRIM HEALTH
MA718822OtherTUFTS HEALTH PLAN
MA718822OtherTUFTS HEALTH PLAN
MAY35602Medicare ID - Type Unspecified