Basic Information
| Provider Information | |||||||||
| NPI: | 1376749358 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GERLACH | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | JOHN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8540 QUADAY NEAVE | ||||||||
| Address2: | |||||||||
| City: | OTSEGO | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553306522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7634410298 | ||||||||
| FaxNumber: | 7634410591 | ||||||||
| Practice Location | |||||||||
| Address1: | 8540 QUADAY AVE, NE | ||||||||
| Address2: | |||||||||
| City: | OTSEGO | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7634410298 | ||||||||
| FaxNumber: | 7632418179 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2007 | ||||||||
| LastUpdateDate: | 04/24/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 2004015118 | MO | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0106X | 53330 | MN | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery | 207XS0106X | ML 60099408 | WA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery |
No ID Information.