Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 20640 | IA |
NPI | 1083610919 |
---|---|
Provider Name | Catherine L Weideman |
First Address | Bettendorf, IA 52722-4159 |
Second Address | Davenport, IA 52804-1889 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
041678 | HEALTH ALLIANCE (01) | |
1201376 | (05) | IA |
19921 | IOWA HEALTH SOLUTIONS (01) | |
31101 | WELLMARK BC/BS (01) | |
A02128 | (02) | |
IL01D6 | JOHN DEERE HEALTH PLAN (01) |