Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0402X | Child Neurologist | 2010031548 | MO |
Y | 2084N0402X | Child Neurologist | 41060 | IA |
N | 2084N0600X | Clinical Neurophysiologist | 41060 | IA |
NPI | 1043418809 |
---|---|
Provider Name | Dr. Michael Anthony Ciliberto |
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 | 03/07/2007 |
Last Update Date | 20/06/2013 |