Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0401X | Internist - Addiction Medicine | 18366 | IA |
Y | 208200000X | Surgeon | 18366 | IA |
Y | 208600000X | Surgeon | 18366 | IA |
NPI | 1548249519 |
---|---|
Provider Name | Gerald Mathew Paluska |
First Address | Ottumwa, IA 52501 |
Second Address | Ottumwa, IA 52501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2006 |
Last Update Date | 16/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
06515 | BCBS (01) | IA |
6158311 | (05) | IA |
7158311 | (05) | IA |
A01381 | (02) |