Provider Demographics
NPI:1245267566
Name:SCHLOSSER, GREGORY A (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:A
Last Name:SCHLOSSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1406 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1900
Mailing Address - Country:US
Mailing Address - Phone:320-229-4944
Mailing Address - Fax:320-229-5156
Practice Address - Street 1:1406 6TH AVE N
Practice Address - Street 2:
Practice Address - City:ST CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1900
Practice Address - Country:US
Practice Address - Phone:320-229-4944
Practice Address - Fax:320-229-5156
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNMN37681208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN94584000Medicaid
MN94584000Medicaid
G05827Medicare UPIN