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Individual

DR. ROBERT WILLIAM GERBER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2690 N 17TH ST, COOS BAY, OR 97420
(541) 269-5333
(541) 269-5609
Mailing address
2690 N 17TH ST, COOS BAY, OR 97420-2134
(541) 269-5333
(541) 269-5609

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD18057
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
047899
OR
01
1407812365
NBMC NPI NUMBER-GROUP
OR
01
CB3544
RR MEDICARE GROUP NUMBER
OR
01
P00088023
RR MEDICARE PTAN NUMBER
OR
01
R0000WFBTV
MEDICARE GROUP PIN
OR
Enumeration date
12/05/2005
Last updated
04/17/2020
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