Individual
MARINA SIDRA GERGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
966 BARTLEY ST, JASPER, IN 47546-2641
(812) 996-5425
Mailing address
515 W 9TH STREET, UNIT A, JASPER, IN 47546
(513) 546-3224
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
11020796A
IN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
11020796A
IN
Other
Enumeration date
07/03/2019
Last updated
07/08/2019
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