Individual
DR. MARK DAVID GERNERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 BROAD STREET, SAINT CATHERINE MEDICAL CENTER FOUNTAIN SPRINGS, ASHLAND, PA 17921
(570) 875-5850
Mailing address
PO BOX 534, 1506 VALLEY VIEW DR, GWYNEDD VALLEY, PA 19437-0534
(215) 699-3943
(215) 699-6027
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD020620E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007278000
TPI GROUP MEDICAID ID
PA
01
—
597586
TPI GROUP MEDICARE PTAN
PA
01
—
CD4829
TPI GROUP RAILROAD MEDICARE
PA
Enumeration date
12/08/2006
Last updated
02/04/2013
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