Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 036-123193 | IL |
N | 207P00000X | Emergency Physician | 36939 | IA |
N | 207P00000X | Emergency Physician | 48566 | MN |
NPI | 1003923467 |
---|---|
Provider Name | Deepta Shankar Atre Strand |
First Address | Iowa City, IA 52246-3510 |
Second Address | Rock Island, IL 61201-5351 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 19/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00741037 | RR MEDICARE (01) | IL |