Healthcare Provider Details

I. General information

NPI: 1023062080
Provider Name (Legal Business Name): RICHARD C GEHRZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5562 COUGAR TRAIL RD
DUBLIN VA
24084
US

IV. Provider business mailing address

PO BOX 969
DUBLIN VA
24084
US

V. Phone/Fax

Practice location:
  • Phone: 540-674-9359
  • Fax: 540-674-1825
Mailing address:
  • Phone: 540-674-9359
  • Fax: 540-674-1825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101050249
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20716
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: