Provider Demographics
NPI:1902801608
Name:GAERTNER, ERICH M (MD)
Entity Type:Individual
Prefix:
First Name:ERICH
Middle Name:M
Last Name:GAERTNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2001 WEBBER ST
Mailing Address - Street 2:C/O SARASOTA PATHOLOGY
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5288
Mailing Address - Country:US
Mailing Address - Phone:941-362-8900
Mailing Address - Fax:941-362-8987
Practice Address - Street 1:2001 WEBBER ST
Practice Address - Street 2:SARASOTA PATHOLOGY
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5288
Practice Address - Country:US
Practice Address - Phone:941-362-8900
Practice Address - Fax:941-362-8987
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2010-02-04
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Provider Licenses
StateLicense IDTaxonomies
FLME79287207ZP0102X, 207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276362100Medicaid
FLAC235ZMedicare PIN