Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 36105 | IA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 36105 | IA |
NPI | 1174540793 |
---|---|
Provider Name | Ericka Andrusiak Lawler |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 27/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0727628 | (05) | IA |
22159 | WELLMARK BCBS (01) | IA |
I59270 | (02) | IA |