MEDICARE: DR. GEORGE ANDREW GEHRKEN JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	0101038299	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	212098	OTHER	VA	CIGNA
4	027132	OTHER	VA	ANTHEM
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396799318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE ANDREW GEHRKEN JR. MD

Provider Business Mailing Address
First Line	:	101 CLEVELAND AVE
Second Line	:	SUITE C
City	:	MARTINSVILLE
State	:	VA
Zip	:	24112-3700
Country	:	US
Telephone Number	:	276-634-5000
Fax Number	:	276-634-5229

Provider Business Practice Location Address
First Line	:	101 CLEVELAND AVE
Second Line	:	SUITE C
City	:	MARTINSVILLE
State	:	VA
Zip	:	24112-3700
Country	:	US
Telephone Number	:	276-634-5000
Fax Number	:	276-634-5229

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	02/25/2009

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