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Individual
GERALD GANTT JR.
Active
Individual
GERALD GANTT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
036143979
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036143979
—
IL
Enumeration date
05/17/2010
Last updated
08/23/2018
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