Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 02945 | IA |
NPI | 1154311256 |
---|---|
Provider Name | Dr. Eric J Stenberg |
First Address | Atkins, IA 52206-9789 |
Second Address | Marshalltown, IA 50158-2924 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G41041 | (02) | IA |