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NPI Code Detail

MEDICARE: DR. DALE R GERSTMANN M.D.

MEDICARE: DR. DALE R GERSTMANN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician184816-1205UT
22080N0001XNeonatal-Perinatal Medicine Physician184816-1205UT

General Provider Information

NPI Number : 1205834843
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DALE R GERSTMANN M.D.
Provider Business Mailing Address
First Line : 730 W 800 N STE 340B
Second Line :
City : OREM
State : UT
Zip : 84057-6300
Country : US
Telephone Number : 801-655-5425
Fax Number : 801-655-5426
Provider Business Practice Location Address
First Line : 750 W 800 N
Second Line :
City : OREM
State : UT
Zip : 84057-3660
Country : US
Telephone Number : 801-714-6511
Fax Number : 801-714-6597
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 09/11/2025

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