Provider Demographics
NPI:1023184397
Name:MEHRHOF, EDWARD GATES (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:GATES
Last Name:MEHRHOF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 BRIAR WOOD RD
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045
Mailing Address - Country:US
Mailing Address - Phone:607-749-4272
Mailing Address - Fax:
Practice Address - Street 1:913 BRIARWOOD RD
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-9137
Practice Address - Country:US
Practice Address - Phone:607-749-4272
Practice Address - Fax:607-749-4272
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0904022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0904022Medicaid