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General NPI Number Information
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NPI Number | 1740570928
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Entity Type | Individual
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Provider Name | ERICA JANE GAUGER M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/09/2011
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 401 PHALEN BLVD
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City | SAINT PAUL
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State | MN
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Zip | 55130-5302
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Country | US
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Telephone | 952-831-8742
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Fax |
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Provider Business Mailing Address
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Address Line | 8100 NORTHLAND DR
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City | BLOOMINGTON
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State | MN
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Zip | 55431-4800
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 62139
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License Number State | MN
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