NPI 1104800192

Kent P Ellerbroek, MD

Practitioner Dermatology Physician Waterloo, IA

Practice location

Address: 541 King Dr, Waterloo, IA 50702-5959
Phone: (319) 235-6323
Fax: (319) 235-0249

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 20213 (IA)

Other Dermatology providers in Iowa →

Registry record

NPI: 1104800192
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Dec 2005
Record last updated: 14 Oct 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.