Basic Information
| Provider Information | |||||||||
| NPI: | 1417368796 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GATHJE | ||||||||
| FirstName: | ERICA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1767 JAMES AVE S | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554032828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5079510218 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8100 42ND AVE N | ||||||||
| Address2: | |||||||||
| City: | NEW HOPE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55427 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7635815700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2014 | ||||||||
| LastUpdateDate: | 11/28/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 59385 | MN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.