Kent P Ellerbroek in Waterloo - Dermatology
Kent P Ellerbroek - NPI 1104800192
Kent P Ellerbroek is a Dermatology in Waterloo, Iowa. Kent P Ellerbroek practices all healthcare services and medical treatments related to Dermatology. The NPI Number for Kent P Ellerbroek is 1104800192. The last update date is 2008-10-14.
Kent P Ellerbroek's current location address is 541 King Dr, Waterloo, Iowa. You can contact this provider via phone number 3192356323 and fax number 3192350249. The mailing address for Kent P Ellerbroek is 541 King Dr, Waterloo, Iowa. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kent P Ellerbroek |
|---|---|
| Address | 541 King Dr, Waterloo, Iowa |
| Phone Number | 3192356323 |
| Fax Number | 3192350249 |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1104800192 |
|---|---|
| Provider Enumeration Date | 2005-12-02 |
| Last Updated Date | 2008-10-14 |
Provider Mailing Address Detail
| Address | 541 King Dr |
|---|---|
| City | Waterloo |
| State | Iowa (IA) |
| Post Code | 507025959 |
| Phone Number | 3192356323 |
| Fax Number | 3192350249 |
Provider's Primary Taxonomy Detail
| Speciality | Dermatology |
|---|---|
| Taxonomy | 207N00000X |
| Licence No | 20213 |
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Definition: A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 169805 | IA | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Kent P Ellerbroek by the Centers for Medicare & Medicaid Services?
The Kent P Ellerbroek has been issued the NPI (National Provider Identifier) 1104800192. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Kent P Ellerbroek's physical address?
The Kent P Ellerbroek is physically located at 541 King Dr, in the city of Waterloo, IA, with the postal code 507025959.
What is Kent P Ellerbroek's specialized field of practice, and what is the corresponding taxonomy classification code?
The Kent P Ellerbroek's area of specialization is Dermatology, and the corresponding taxonomy code that categorizes this field of practice is 207N00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1104800192 to Kent P Ellerbroek?
The Kent P Ellerbroek received its 1104800192 assignment from the Centers for Medicare & Medicaid Services on 2005-12-02.
When was the information related to Kent P Ellerbroek most recently updated or refreshed?
The details pertaining to the Kent P Ellerbroek, including its address, specialty, and other relevant information, were last updated or refreshed on 2008-10-14.