Provider Demographics
NPI:1396795779
Name:DREESSEN, ADRIAN (MD)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:DREESSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 HEMPSTEAD STATION DR
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-5164
Mailing Address - Country:US
Mailing Address - Phone:800-875-0136
Mailing Address - Fax:937-619-4342
Practice Address - Street 1:800 MERCY DR
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-3128
Practice Address - Country:US
Practice Address - Phone:712-328-5230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA35225207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE233301OtherMLDCH AND MUTL OF OMAHA
NE100251147-00Medicaid
IA39-01551OtherSHARE ADVNT IOWA
NE100249951-00Medicaid
NEP00068630OtherRAILORAD MEDICARE
IAP00116322OtherRRCARE FOR IOWA
NE100251217-00Medicaid
NE39-01552OtherSHAREADVANTAGE
IA01304OtherBCBSNE FOR IOWA
IA3568014Medicaid
NE39-01550OtherSHAREADVANTAGE
IA5568014Medicaid
IA4568014Medicaid
NE01173OtherBCBS
35229OtherBCBS
NE100251217-00Medicaid
NE01173OtherBCBS
NE39-01550OtherSHAREADVANTAGE
NE100251147-00Medicaid