Individual
DR. MARK ANDREW GERSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4676 DOUGLAS CIR NW, CANTON, OH 44718-3619
(330) 494-1116
(330) 494-0276
Mailing address
4676 DOUGLAS CIR NW, CANTON, OH 44718-3619
(330) 494-1116
(330) 494-0276
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
18631
WV
207W00000X
Ophthalmology Physician
35060285
OH
207W00000X
Ophthalmology Physician
MD057570L
PA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
35.060285
OH
207WX0107X
Retina Specialist (Ophthalmology) Physician
MD057570L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015118570004
—
PA
05
—
0096237000
—
WV
05
—
0975753
—
OH
01
—
180041827
RRMCR # OTHER TAX ID
OH
01
—
4036611
MCR # OTHER TAX ID
OH
Enumeration date
05/31/2005
Last updated
05/24/2021
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