Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 34639 | IA |
Y | 207RX0202X | Medical Oncology | 34639 | IA |
NPI | 1063461689 |
---|---|
Provider Name | Deborah W Wilbur |
First Address | Cedar Rapids, IA 52403-1251 |
Second Address | Cedar Rapids, IA 52403-1251 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 12/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11429 | WELLMARK BC/BS (01) | IA |
1264549 | (05) | IA |
H75864 | (02) | IA |
P00321055 | RAILROAD MEDICARE (01) | IA |