Provider Demographics
NPI:1245347772
Name:GEHMAN, JOHN E SR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:GEHMAN
Suffix:SR
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:PO BOX 185
Mailing Address - Street 2:
Mailing Address - City:CREWE
Mailing Address - State:VA
Mailing Address - Zip Code:23930-0185
Mailing Address - Country:US
Mailing Address - Phone:434-538-0345
Mailing Address - Fax:434-538-0285
Practice Address - Street 1:306 CUSTIS ST # A
Practice Address - Street 2:
Practice Address - City:CREWE
Practice Address - State:VA
Practice Address - Zip Code:23930-2016
Practice Address - Country:US
Practice Address - Phone:434-538-0345
Practice Address - Fax:434-538-0285
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101016882208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010249431Medicaid
VA00X283H01Medicare PIN
VA00X850Medicare PIN
VAVV94640281Medicare PIN
VA010249431Medicaid