Individual
JEFFREY THOMAS EHRETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
18730
SC
2088P0231X
Pediatric Urology Physician
Primary
18730
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G17963F935
MEDICARE
SC
05
—
Q00563
—
SC
Enumeration date
06/30/2006
Last updated
04/16/2021
Update your record
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