Provider Demographics
NPI:1518233428
Name:MORTENSEN, GARRETT FILAS (MD)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:FILAS
Last Name:MORTENSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1500 ASSOCIATES DR
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-2201
Mailing Address - Country:US
Mailing Address - Phone:563-584-4112
Mailing Address - Fax:563-584-4110
Practice Address - Street 1:1000 LANGWORTHY ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001
Practice Address - Country:US
Practice Address - Phone:563-584-3450
Practice Address - Fax:563-584-3171
Is Sole Proprietor?:No
Enumeration Date:2012-03-25
Last Update Date:2018-08-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IAMD45491208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery