Provider Demographics
NPI:1336234244
Name:GERLEMAN, BRENT F (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:F
Last Name:GERLEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3600 30TH ST
Mailing Address - Street 2:VA CENTRAL IOWA HEALTHCARE
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-5753
Mailing Address - Country:US
Mailing Address - Phone:515-699-5825
Mailing Address - Fax:515-699-5906
Practice Address - Street 1:3600 30TH ST
Practice Address - Street 2:VA CENTRAL IOWA HEALTHCARE
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-5753
Practice Address - Country:US
Practice Address - Phone:515-699-5825
Practice Address - Fax:515-699-5906
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA22299207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAA02182Medicare UPIN