Individual
ETHAN ALONSO GERDTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 MANNING DR, CHAPEL HILL, NC 27514-4220
(984) 974-1000
Mailing address
9162 REGENTS RD APT C, LA JOLLA, CA 92037-1448
(714) 618-2192
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A185506
CA
390200000X
Student in an Organized Health Care Education/Training Program
260936
NC
Other
Enumeration date
04/25/2020
Last updated
06/09/2023
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