Provider Demographics
NPI:1770550899
Name:GEHRS, MELINDA A (MD)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:A
Last Name:GEHRS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 W MOUNTAIN VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-3128
Mailing Address - Country:US
Mailing Address - Phone:303-485-3323
Mailing Address - Fax:303-494-3113
Practice Address - Street 1:1925 W MOUNTAIN VIEW AVE
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3128
Practice Address - Country:US
Practice Address - Phone:303-485-3323
Practice Address - Fax:303-494-3113
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00380892081S0010X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7573847Medicaid
CO38089OtherCOLORADO BME
CO7573847Medicaid
CO805068Medicare PIN
CO342271YLB8Medicare PIN