Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 22877 | IA |
N | 207VX0201X | Gynecologic Oncologist | 22877 | IA |
NPI | 1003803867 |
---|---|
Provider Name | Barrie Anderson |
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 | 05/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0190918 | (05) | IA |
19091 | WELLMARK BCBS (01) | IA |
A01923 | (02) |