Provider Demographics
NPI:1396785002
Name:ERHARD, LISA (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:ERHARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3366 OAKDALE AVE N
Mailing Address - Street 2:SUITE 450
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2948
Mailing Address - Country:US
Mailing Address - Phone:763-587-7000
Mailing Address - Fax:763-587-7015
Practice Address - Street 1:3366 OAKDALE AVE N
Practice Address - Street 2:SUITE 450
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2948
Practice Address - Country:US
Practice Address - Phone:763-587-7000
Practice Address - Fax:763-587-7015
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN33512207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN615323200Medicaid
MN615323200Medicaid