MEDICARE: DONALD EUGENE GEHRIG MD

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	207R00000X	Internal Medicine Physician	25153	MN

General Provider Information

NPI Number	:	1619997194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD EUGENE GEHRIG MD

Provider Business Mailing Address
First Line	:	393 DUNLAP ST N
Second Line	:	SUITE 834
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-4200
Country	:	US
Telephone Number	:	651-644-5610
Fax Number	:	651-644-1039

Provider Business Practice Location Address
First Line	:	393 DUNLAP ST N
Second Line	:	SUITE 834
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-4200
Country	:	US
Telephone Number	:	651-644-5610
Fax Number	:	651-644-1039

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

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	07/08/2007

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