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Individual

GERHARDT STEFAN WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
360 SHERMAN ST STE 390, SAINT PAUL, MN 55102-3865
(651) 383-4800
Mailing address
100 LINDEN OAKS STE 200, ROCHESTER, NY 14625-2831
(585) 368-6700
(585) 368-6767

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
268023
NY
2084P0800X
Psychiatry Physician
Primary
80478
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
J400084743
MEDICARE GROUP PTAN: J100044293
NY
Enumeration date
07/02/2008
Last updated
11/10/2025
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