Provider Demographics
NPI:1043573025
Name:NEVERMAN, ERIC MITCHELL (DO)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:MITCHELL
Last Name:NEVERMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:101 E J AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:GRUNDY CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:50638-2004
Mailing Address - Country:US
Mailing Address - Phone:319-824-6945
Mailing Address - Fax:319-824-6947
Practice Address - Street 1:101 E J AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:GRUNDY CENTER
Practice Address - State:IA
Practice Address - Zip Code:50638-2004
Practice Address - Country:US
Practice Address - Phone:319-824-6945
Practice Address - Fax:319-824-6947
Is Sole Proprietor?:No
Enumeration Date:2012-06-24
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2012020299207R00000X, 208000000X
IADO-04776207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics