Individual
MARK E HERMANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
865 LINCOLN RD, STE 400, BETTENDORF, IA 52722-4159
(563) 359-7548
(563) 359-7540
Mailing address
865 LINCOLN RD, STE L10, BETTENDORF, IA 52722-4159
(563) 355-9191
(563) 355-3419
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22112
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034785
HEALTH ALLIANCE
—
01
—
19867
IOWA HEALTH SOLUTIONS
—
01
—
29591
WELLMARK BC/BS
—
05
—
3193615
—
IA
01
—
4796890004
DMERC
—
01
—
IA0137
JOHN DEERE HEALTH PLAN
—
Enumeration date
06/20/2005
Last updated
11/21/2007
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