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Contact Information

SAMUEL GERVAIS, DPM
601 JACOB LN
ANOKA, MN55303
 Phone: 763-587-4200
 Fax: 763-587-4205
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for SAMUEL GERVAIS · (Male)

NPI # 1396150793
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 06/24/2014
Last updated 04/29/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 964
Hospital affiliation(s)
  • MERCY HOSPITAL - (Acute Care)
    4050 COON RAPIDS BLVD
    COON RAPIDS, MN 55433
  • REGIONS HOSPITAL - (Acute Care)
    640 JACKSON STREET
    SAINT PAUL, MN 55101
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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