Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 21877 | IA |
NPI | 1003802984 |
---|---|
Provider Name | Dr. David H Stubbs |
First Address | Des Moines, IA 50306-4907 |
Second Address | Des Moines, IA 50314-1708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A01553 | (02) | IA |