MEDICARE: DR. HERMAN GRANT GERHARDT DO

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	207L00000X	Anesthesiology Physician	DR.0063052	CO

General Provider Information

NPI Number	:	1396193306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERMAN GRANT GERHARDT DO

Provider Business Mailing Address
First Line	:	PO BOX 308
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81502-0308
Country	:	US
Telephone Number	:	970-254-1686
Fax Number	:	970-254-1687

Provider Business Practice Location Address
First Line	:	2351 G RD
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81505-9641
Country	:	US
Telephone Number	:	970-254-1686
Fax Number	:

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

Provider Enumeration Date	:	05/31/2016
Last Update Date	:	03/18/2026

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