Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | R-8588 | IA |
NPI | 1003043035 |
---|---|
Provider Name | Dr. Sameer Bharat Nathoo |
First Address | Cedar Rapids, IA 52402-5064 |
Second Address | Cedar Rapids, IA 52403-4009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2009 |
Last Update Date | 27/03/2012 |