Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 36653 | IA |
N | 111NI0900X | Internist | 36653 | IA |
N | 207RH0002X | Hospice and Palliative Medicine | 36653 | IA |
NPI | 1063449387 |
---|---|
Provider Name | Dr. Tracy M. Reittinger |
First Address | Dubuque, IA 52002-2201 |
Second Address | Dubuque, IA 52001-7320 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 18/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1063449387 | (05) | IA |
1063449387 | (05) | WI |
1063449387 | BCBS (01) | IA |
96730757 | (05) | CO |