Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | A05580 | IA |
Y | 213ER0200X | Radiology | A05580 | IA |
NPI | 1629095625 |
---|---|
Provider Name | Dr. Dennis Michael Marchiori |
First Address | Bettendorf, IA 52722-0024 |
Second Address | Bettendorf, IA 52722-0024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U58367 | (02) |