Gerhardt, Dietrich A

Gerhardt, Dietrich A is an individual health care provider with primary practice located at 1970 E 53Rd St , Davenport IA 52807-2710. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Gerhardt, Dietrich A can be contacted via phone (563) 359-3949.

Contact Information

Primary practice address
1970 E 53Rd St Davenport IA 52807-2710
Phone: (563) 359-3949
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 32049 Iowa

Profile Details

NPI number 1396705711
LBN Legal business name Gerhardt, Dietrich A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Apr 12th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396705711 NPPES
Other 03734 BCBS IA RGIC LLC
MEDICAID 2189506 BCBS IA RGIC LLC
MEDICAID 1189506 BCBS IA RGIC LLC
Other 25999 BCBS IA RGIC LLC
Other 01297 BCBS IA RGIC LLC
Other P000275282 BCBS IA RGIC LLC
Other 3189506 BCBS IA RGIC LLC
Other I18223 BCBS IA RGIC LLC
Other K51233 BCBS IA RGIC LLC

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