Individual
GREGORY NEAL LERVICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4010 W 65TH ST, EDINA, MN 55435-1706
(952) 456-7000
(952) 456-7001
Mailing address
4200 DAHLBERG DR STE 300, GOLDEN VALLEY, MN 55422-4841
(952) 512-5600
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
45031
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
328275900
—
MN
Enumeration date
08/24/2006
Last updated
01/04/2023
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