Provider Demographics
NPI:1417121088
Name:GEHRIG, KATHRYN AMELIA (MD)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:AMELIA
Last Name:GEHRIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14305 SOUTHCROSS DR W, SUITE 110
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-7009
Mailing Address - Country:US
Mailing Address - Phone:651-340-1064
Mailing Address - Fax:651-330-0429
Practice Address - Street 1:14001 RIDGEDALE DR STE 300
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1783
Practice Address - Country:US
Practice Address - Phone:763-316-4407
Practice Address - Fax:952-303-3579
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN53890207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology