Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | SP-0234 | IA |
N | 111NI0900X | Internist | SP-0234 | IA |
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | R-11075 | IA |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | SP-0234 | IA |
N | 207RC0000X | Internist - Cardiovascular Disease | SP-0234 | IA |
NPI | 1215439708 |
---|---|
Provider Name | Dr. Ernesto Anibal Ruiz Duque |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2018 |
Last Update Date | 30/06/2019 |