Robert M Gerson, MD
Individual provider Active NPI Plastic Surgery Physician · Walworth, WI
NPI 1881746709 · NPPES record last updated Feb 2, 2023
Key facts
- NPI
- 1881746709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Plastic Surgery Physician 208200000X
- License
- 25931 (WI)
- Practice address
- 841 Red Hawk Dr
Walworth, WI 53184-9707 - Phone
- (262) 903-2299
- NPI assigned
- Jan 18, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 25931 | WI | Yes |
Addresses
Primary practice location
841 Red Hawk Dr
Walworth, WI 53184-9707
Mailing address
841 Red Hawk Dr
Walworth, WI 53184-9707
Phone (262) 903-2299
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32097500 | Medicaid | WI | |
| 0360622742 | Medicaid | IL |
Other providers in Walworth, WI
- Center for Change, LLC
- Stephen Andrew Cole
- Bernice Lorraine Elliott
- Mary E. Frazier
- Hollyanne George
- Nathan C Gilling
- Golden Years Nursing Home, Inc.
- Samantha Golembiewski
- Megan R Hopp
- Dale Gary Jacobson
All providers in Walworth, WI · Plastic Surgery Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.