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General NPI Number Information
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NPI Number | 1205834843
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Entity Type | Individual
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Provider Name | DALE R GERSTMANN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 750 W 800 N
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City | OREM
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State | UT
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Zip | 84057-3660
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Country | US
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Telephone | 801-714-6511
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Fax | 801-714-6597
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Provider Business Mailing Address
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Address Line | 730 W 800 N STE 340B
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City | OREM
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State | UT
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Zip | 84057-6300
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Country | US
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Telephone | 801-655-5425
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Fax | 801-655-5426
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 184816-1205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 184816-1205
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License Number State | UT
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