Individual
DR. STEPHAN O GERLACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
250 SMITH CHURCH RD, ROANOKE RAPIDS, NC 27870-4914
(252) 535-5011
Mailing address
250 SMITH CHURCH RD, ROANOKE RAPIDS, NC 27870-4914
(252) 535-5011
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
9801653
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11972
BLUE CROSS PIN
NC
01
—
560989789
TAX ID
NC
05
—
8911972
—
NC
Enumeration date
03/12/2007
Last updated
01/14/2022
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