Healthcare Provider Details

I. General information

NPI: 1699842138
Provider Name (Legal Business Name): JOHN GREGORY LUEHR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12301 WHITEWATER DR STE 101
MINNETONKA MN
55343
US

IV. Provider business mailing address

9400 ZANE AVE N
BROOKLYN PARK MN
55443-1814
US

V. Phone/Fax

Practice location:
  • Phone: 952-999-6097
  • Fax: 952-426-0508
Mailing address:
  • Phone: 612-275-4478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number31788
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number31788
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: