Individual
DR. KELLY SCOTT POMERENKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
240 N RERICK AVE, PRIMGHAR, IA 51245-7786
(712) 957-2310
Mailing address
240 N RERICK AVE, PRIMGHAR, IA 51245-7786
(712) 957-2310
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27695
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1057729
—
IA
Enumeration date
10/26/2005
Last updated
04/22/2024
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