Provider Demographics
NPI:1861675985
Name:EDWARD E GAHRES, MS, LTD
Entity Type:Organization
Organization Name:EDWARD E GAHRES, MS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:ELIAS
Authorized Official - Last Name:GAHRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-931-7515
Mailing Address - Street 1:5021 SEMINARY RD
Mailing Address - Street 2:109
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1994
Mailing Address - Country:US
Mailing Address - Phone:703-931-7515
Mailing Address - Fax:703-931-9524
Practice Address - Street 1:5021 SEMINARY RD
Practice Address - Street 2:109
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1994
Practice Address - Country:US
Practice Address - Phone:703-931-7515
Practice Address - Fax:703-931-9524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101-013586207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
210847OtherMAMSI
VA015170OtherANTHEM BCBS
79690002OtherBCBS
10232085OtherAMERIGROUP
0700409OtherUNITED HEALTH CARE
410090Medicare PIN