| NPI | 1942516471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP DEWAIN SUNDQUIST Family Practice/Obgyn 641-217-9115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 37367) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IA 37367) |
| Enumeration Date | 2010-08-21 |
| Last Update Date | 2010-12-08 |