Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 12774 | NH |
Y | 204F00000X | Transplant Surgeon | MD-45522 | IA |
N | 208200000X | Surgeon | 12774 | NH |
N | 208600000X | Surgeon | 12774 | NH |
N | 2086S0102X | Surgical Critical Care | 12774 | NH |
N | 2086S0102X | Surgical Critical Care | MD-45522 | IA |
NPI | 1477574820 |
---|---|
Provider Name | Dr. David Adam Axelrod |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 14/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1011731 | (05) | VT |
3072491 | (05) | NH |
I35037 | (02) |