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Individual

GREGORY MARK EBERHART

Active
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Individual

GREGORY MARK EBERHART

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35074110
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000244980
ANTHEM
01
0069964001
CIGNA
01
10790951
CAQH
01
1201765
UHC
01
2032058
AETNA
05
2059856
OH
05
2368834
OH
01
36D1007721
CLIA
01
522374873
TAX ID
01
522374873029
CARESOURCE
01
C09331561
MEDICARE GROUP PIN
01
D7411004
HUMANA
01
G23791
NATIONAL PROVIDER ID
Enumeration date
01/09/2006
Last updated
03/05/2026
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