Justin Craig Ellerbroek in Waterloo - Mohs-micrographic Surgery
Justin Craig Ellerbroek - NPI 1790981207
Justin Craig Ellerbroek is a Mohs-micrographic Surgery in Waterloo, Iowa. Justin Craig Ellerbroek practices all healthcare services and medical treatments related to Mohs-micrographic Surgery. The NPI Number for Justin Craig Ellerbroek is 1790981207. The last update date is 2015-07-30.
Justin Craig Ellerbroek's current location address is 441 E San Marnan Dr, Waterloo, Iowa. You can contact this provider via phone number 3192346000 and fax number 3192346001. The mailing address for Justin Craig Ellerbroek is 441 E San Marnan Dr, Waterloo, Iowa. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Justin Craig Ellerbroek |
|---|---|
| Address | 441 E San Marnan Dr, Waterloo, Iowa |
| Phone Number | 3192346000 |
| Fax Number | 3192346001 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1790981207 |
|---|---|
| Provider Enumeration Date | 2007-06-22 |
| Last Updated Date | 2015-07-30 |
Provider Mailing Address Detail
| Address | 441 E San Marnan Dr |
|---|---|
| City | Waterloo |
| State | Iowa (IA) |
| Post Code | 507025900 |
| Phone Number | 3192346000 |
| Fax Number | 3192346001 |
Provider's Primary Taxonomy Detail
| Speciality | Mohs-micrographic Surgery |
|---|---|
| Taxonomy | 207Nd0101X |
| Licence No | 38816 |
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Definition: The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving |
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What is the unique identifier code issued to Justin Craig Ellerbroek by the Centers for Medicare & Medicaid Services?
The Justin Craig Ellerbroek has been assigned the NPI (National Provider Identifier) 1790981207. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Justin Craig Ellerbroek is physically located?
The Justin Craig Ellerbroek is physically situated at the following address: 441 E San Marnan Dr, Waterloo, IA, 507025900.
What is Justin Craig Ellerbroek's area of expertise and its corresponding taxonomy classification?
The Justin Craig Ellerbroek's field of specialization is Mohs-micrographic Surgery, and it falls under the taxonomy code 207Nd0101X, which categorizes healthcare providers based on their areas of practice.
On what date was the 1790981207 assigned to Justin Craig Ellerbroek?
The Justin Craig Ellerbroek was issued its 1790981207 on 2007-06-22, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Justin Craig Ellerbroek most recently updated?
The details pertaining to the Justin Craig Ellerbroek, including its address, specialty, and other relevant information, were last refreshed on 2015-07-30.
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