Basic Information
| Provider Information | |||||||||
| NPI: | 1780211680 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GEHRIG | ||||||||
| FirstName: | MICH | ||||||||
| MiddleName: | ANDREW | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | HUMBOLDT GENERAL HOSPITAL | ||||||||
| Address2: | 118 EAST HASKELL ST | ||||||||
| City: | WINNEMUCCA | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7756235222 | ||||||||
| FaxNumber: | 7756233567 | ||||||||
| Practice Location | |||||||||
| Address1: | HUMBOLDT GENERAL HOSPITAL | ||||||||
| Address2: | 118 EAST HASKELL ST | ||||||||
| City: | WINNEMUCCA | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7756235222 | ||||||||
| FaxNumber: | 7756233567 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2020 | ||||||||
| LastUpdateDate: | 03/23/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.