NPI | 1548452287 |
---|---|
Entity Type | Organization |
Authorized Contact | CRAIG S GERHART Md President Of The Corporation 515-964-7965 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 20200) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 02946) |
Enumeration Date | 2007-08-16 |
Last Update Date | 2007-10-02 |