MEDICARE: BRADY GERBER PA-C

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
1	363A00000X	Physician Assistant	083631	IA

General Provider Information

NPI Number	:	1225584329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADY GERBER PA-C

Provider Business Mailing Address
First Line	:	PO BOX 1475
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50305-1475
Country	:	US
Telephone Number	:	515-358-7300
Fax Number	:	515-358-7341

Provider Business Practice Location Address
First Line	:	2755 S. GATEWAY DRIVE
Second Line	:
City	:	CARLISLE
State	:	IA
Zip	:	50047-2301
Country	:	US
Telephone Number	:	515-358-7300
Fax Number	:	515-358-7341

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2016
Last Update Date	:	12/01/2017

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Directions to “ BRADY GERBER PA-C” Practice Location

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