Individual
JOHN W GFRERER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15245 BLUEBIRD ST NW, MAIL STOP 39200A, ANDOVER, MN 55304-3554
(763) 712-6000
(763) 712-6090
Mailing address
15245 BLUEBIRD ST NW, 21110Q, ANDOVER, MN 55304-3554
(763) 587-4600
(763) 587-4615
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22852
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
695587800
—
MN
Enumeration date
02/14/2006
Last updated
05/30/2014
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