Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0201X | Internist - Allergy & Immunology | 22745 | IA |
N | 207RC0200X | Critical Care Medicine | 22745 | IA |
Y | 207RP1001X | Pulmonary Disease | 22745 | IA |
NPI | 1619965522 |
---|---|
Provider Name | Gary W Hunninghake |
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 | 13/10/2005 |
Last Update Date | 04/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0187260 | (05) | IA |
18726 | WELLMARK BCBS (01) | IA |
A01872 | (02) |