Provider Demographics
NPI:1689779787
Name:GEHRKE, SEAN DALE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:DALE
Last Name:GEHRKE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2880 UNIVERSITY AVE
Mailing Address - Street 2:UW HEALTH PHARMACY SERVICES - UNIVERSITY STATION
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3644
Mailing Address - Country:US
Mailing Address - Phone:608-263-9393
Mailing Address - Fax:608-263-7945
Practice Address - Street 1:2880 UNIVERSITY AVE
Practice Address - Street 2:UW HEALTH PHARMACY SERVICES - UNIVERSITY STATION
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3644
Practice Address - Country:US
Practice Address - Phone:608-263-9393
Practice Address - Fax:608-263-7945
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13766 - 040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist