Provider Demographics
NPI:1598763286
Name:RICHMAN, BRETT R (MD)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:R
Last Name:RICHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 S HACKETT RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-3500
Mailing Address - Country:US
Mailing Address - Phone:319-266-5491
Mailing Address - Fax:319-266-6687
Practice Address - Street 1:1015 S HACKETT RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-3500
Practice Address - Country:US
Practice Address - Phone:319-266-5491
Practice Address - Fax:319-266-6687
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA31099207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0134OtherJOHN DEERE HEALTH CARE
160031019OtherRAILROAD MEDICARE
53649OtherWELLMARK
IA0137356Medicaid
IA0134OtherJOHN DEERE HEALTH CARE
IA0137356Medicaid