Provider Demographics
NPI:1619997194
Name:GEHRIG, DONALD EUGENE (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:EUGENE
Last Name:GEHRIG
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 1:393 DUNLAP ST N
Mailing Address - Street 2:SUITE 834
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4200
Mailing Address - Country:US
Mailing Address - Phone:651-644-5610
Mailing Address - Fax:651-644-1039
Practice Address - Street 1:393 DUNLAP ST N
Practice Address - Street 2:SUITE 834
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4200
Practice Address - Country:US
Practice Address - Phone:651-644-5610
Practice Address - Fax:651-644-1039
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN25153207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A94960Medicare UPIN