Provider Demographics
NPI:1316185838
Name:GERHART, VICTORIA RAE (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:RAE
Last Name:GERHART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VICTORIA
Other - Middle Name:RAE
Other - Last Name:COBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2513 S ROOSEVELT CIR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-3231
Mailing Address - Country:US
Mailing Address - Phone:605-362-7840
Mailing Address - Fax:
Practice Address - Street 1:2513 S ROOSEVELT CIR
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-3231
Practice Address - Country:US
Practice Address - Phone:605-362-7840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD3474207L00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology