Provider Demographics
NPI:1174055321
Name:BUERMAN, GINELLE RAE (MD)
Entity type:Individual
Prefix:MRS
First Name:GINELLE
Middle Name:RAE
Last Name:BUERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W 1ST STREET
Mailing Address - Street 2:
Mailing Address - City:PAYNESVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56362
Mailing Address - Country:US
Mailing Address - Phone:320-243-3767
Mailing Address - Fax:320-243-3174
Practice Address - Street 1:200 W 1ST STREET
Practice Address - Street 2:
Practice Address - City:PAYNESVILLE
Practice Address - State:MN
Practice Address - Zip Code:56362
Practice Address - Country:US
Practice Address - Phone:320-243-3767
Practice Address - Fax:320-243-3174
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN66659207Q00000X
WI69904207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program