1881676823 NPI number — MR. AMAR NATH M.D.

Table of content: MR. AMAR NATH M.D. (NPI 1881676823)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881676823 NPI number — MR. AMAR NATH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NATH
Provider First Name:
AMAR
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881676823
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/11/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1301 PENN AVE
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
DES MOINES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50316-2350
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-263-2400
Provider Business Mailing Address Fax Number:
515-263-2540

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 PENN AVENUE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50316-2364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-263-2400
Provider Business Practice Location Address Fax Number:
515-263-2540
Provider Enumeration Date:
11/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  MD-24059 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1881676823 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 060020777 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0066811 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: CS9044 . This is a "RAILROAD MEDICARE GROUP #" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com