Provider Demographics
NPI:1346233731
Name:GILBERT, AMY LOREEN (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:LOREEN
Last Name:GILBERT
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 HAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-6232
Mailing Address - Country:US
Mailing Address - Phone:651-494-7794
Mailing Address - Fax:
Practice Address - Street 1:1608 HAGUE AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-6232
Practice Address - Country:US
Practice Address - Phone:651-494-7794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN36291207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN382015700Medicaid
F73777Medicare UPIN