Provider Demographics
NPI:1861480055
Name:GEHRMANN, FREDERICK (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:
Last Name:GEHRMANN
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 1:1000 N OAK AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-5703
Mailing Address - Country:US
Mailing Address - Phone:715-387-5511
Mailing Address - Fax:
Practice Address - Street 1:1000 N OAK AVE
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-5703
Practice Address - Country:US
Practice Address - Phone:715-387-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1879207L00000X
IL036091107207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL031806OtherCHAMPUS/TRICARE
IL08415040OtherBLUE CROSS
IL104409OtherHEALTHLINK GROUP NUMBER
IL32490OtherPERSONAL CARE
IL085972OtherHEALTH ALLIANCE NUMBER
IL036091107Medicaid
IL274175OtherHEALTHLINK UPIN #
ILG13808Medicare UPIN
IL104409OtherHEALTHLINK GROUP NUMBER
IL1285290Medicare ID - Type UnspecifiedMEDICARE UMWA #
IL32490OtherPERSONAL CARE