Basic Information
| Provider Information | |||||||||
| NPI: | 1306875513 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GERLACH | ||||||||
| FirstName: | DETLEF | ||||||||
| MiddleName: | HORST | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1803 MOUNT ROSE AVE | ||||||||
| Address2: | SUITE B3 | ||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178511405 | ||||||||
| FaxNumber: | 7178516969 | ||||||||
| Practice Location | |||||||||
| Address1: | 1399 S QUEEN ST | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033840 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178122316 | ||||||||
| FaxNumber: | 7178122165 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2006 | ||||||||
| LastUpdateDate: | 01/02/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | MD021900E | PA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 0068413000 | 01 | PA | AMERIHEALTH 65 PA | OTHER | 020424 | 01 | PA | JOHNS HOPKINS | OTHER | 533254 | 01 | PA | MAMSI-WMG | OTHER | 4296808 | 01 | PA | AETNA | OTHER | 81672 | 01 | PA | UNISON-WMG | OTHER | 525990 | 01 | MD | CAREFIRST MD BCBS | OTHER | 1503626 | 01 | PA | GATEWAY-WMG | OTHER | 38918 | 01 | PA | GEISINGER | OTHER | 093807 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | 01530702 | 01 | PA | CAPITAL BLUE CROSS-WMG | OTHER | 1117732 | 01 | PA | AMERIHEALTH MERCY-WMG | OTHER |