Provider Demographics
NPI:1851653570
Name:EHLERT BIRRIEL, GARY WALTER JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:WALTER
Last Name:EHLERT BIRRIEL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GARY
Other - Middle Name:WALTER
Other - Last Name:EHLERT BIRRIEL
Other - Suffix:JR
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:COND. COLINA REAL APT. 3H
Mailing Address - Street 2:2000 AVE. FELIZA RINCON DE GAUTIER
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-448-1633
Mailing Address - Fax:
Practice Address - Street 1:COND. COLINA REAL APT. 3H
Practice Address - Street 2:2000 AVE. FELIZA RINCON DE GAUTIER
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-448-1633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18904207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine