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General NPI Number Information
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NPI Number | 1821040403
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Entity Type | Individual
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Provider Name | WILLIAM GERSHAN MD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 2512 S 7TH ST UMPHYSICIANS PEDIATRIC SPECIALTY CARE-7TH ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55454-1404
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Country | US
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Telephone | 612-365-6777
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Fax | 612-365-8001
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Provider Business Mailing Address
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Address Line | 720 WASHINGTON AVE SE STE 300 UNIVERSITY OF MINNESOTA PHYSICIANS
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City | MINNEAPOLIS
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State | MN
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Zip | 55414-2904
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Country | US
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Telephone | 612-365-6777
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Fax | 612-365-8001
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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 | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | 58034
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License Number State | MN
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