Provider Demographics
NPI:1295721926
Name:GELRUD, LOUIS G (MD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:G
Last Name:GELRUD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2369 STAPLES MILL RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-2918
Mailing Address - Country:US
Mailing Address - Phone:804-285-4465
Mailing Address - Fax:804-285-8332
Practice Address - Street 1:5855 BREMO RD
Practice Address - Street 2:SUITE 706
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1926
Practice Address - Country:US
Practice Address - Phone:804-285-8206
Practice Address - Fax:804-285-0162
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2010-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101026977207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006062580Medicaid
B61405Medicare UPIN
VA006062580Medicaid