Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 4301094490 | MI |
Y | 207SG0201X | Clinical Genetics (M.D.) | MD-44529 | IA |
N | 208000000X | Pediatrician | 4301094490 | MI |
N | 208000000X | Pediatrician | MD-44529 | IA |
NPI | 1700015864 |
---|---|
Provider Name | Alpa Sidhu |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2009 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1700015864 | (05) | MI |